Long-term survival of individuals born with congenital heart disease: A systematic review and meta-analysis

Background-estimates of long-term survival are required to adequately assess the variety of health and social services required by those with congenital heart disease (chd) throughout their lives. methods and results-medline,embase,and scopus were searched from inception to june 2015 using mesh headings and keywords. population-based studies that ascertained all persons born with chd within a predefined area and reported survival estimates at ≥5 years were included. unadjusted survival estimates for each chd subtype at ages 1 year,5 years,10 years,and so forth were extracted. pooled survival estimates for each age were calculated using meta-analyses. metaregression was performed to examine the impact of study period on survival. of 7840 identified articles,16 met the inclusion criteria. among those with chd,pooled 1-year survival was 87.0% (95% ci 82.1-91.2),pooled 5-year survival was 85.4% (95% ci 79.4-90.5),and pooled 10-year survival was 81.4% (95% ci 73.8-87.9). there was significant heterogeneity of survival estimates among articles (p < 0.001 for 1-,5-,and 10-year survival). a more recent study period was significantly associated with greater survival at ages 1 year (p=0.047),5 years (p=0.013),and 10 years (p=0.046). survival varied by chd subtype,with 5-year survival being greatest for those with ventricular septal defect (96.3%,95% ci 93.7-98.2) and lowest for those with hypoplastic left heart (12.5%,95% ci 0.0-41.4). conclusions-among persons with chd,the mortality rate is greatest during the first year of life; however,this systematic review and meta-analysis showed that survival decreases gradually after infancy and into adulthood. © 2016 the authors.