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  1. Leong MC, Memon MKY, Basran NF, Azeman NA, Tho YC, Soo KW
    Pediatr Cardiol, 2026 Aug;47(6):2738-2747.
    PMID: 41060343 DOI: 10.1007/s00246-025-04056-4
    Surgical outcome data on adolescent and adult congenital heart disease (CHD) undergoing cardiac surgery remains scarce in developing economies. The study aims to evaluate the clinical characteristics and postoperative outcomes in this population, with a focus on identifying risk factors to guide quality improvement initiatives. This retrospective cohort study analyzed 569 CHD patients (aged > 12 years) who underwent surgery at a tertiary center (2018-2023). Data included demographics, surgical details, and clinical outcomes. Major adverse events (MAEs) were defined as cardiopulmonary resuscitation, chest reopening for resuscitation, extracorporeal membrane oxygenation, or death. Univariate and multivariate logistic regressions were performed to identify predictors of MAEs. The median age at surgery was 19.7 years; 42.4% underwent redo sternotomy. Complications occurred in 60.1% of patients, with MAEs in 4.9% and mortality in 2.1%. Multivariate analysis identified significant postoperative bleeding (OR 583.62, 95% CI 16.24-20,970.32) as the main predictor of MAEs. Redo sternotomy doubled the risk of a significant postoperative bleeding (15.4% vs. 6.7%, p 
  2. Tye SK, Razali NS, Ahmad Shauqi SA, Azeman NA, Basran NF, Liew JHJ, et al.
    Cardiol Young, 2024 Apr;34(4):900-905.
    PMID: 37965721 DOI: 10.1017/S1047951123003773
    OBJECTIVES: This study aimed to describe the perception of Malaysian patients with pulmonary hypertension towards palliative care and their receptivity towards palliative care.

    METHODS: This was a cross-sectional, single-centre study conducted via questionnaire. Patients aged 18 years old and above, who were diagnosed with non-curable pulmonary hypertension were recruited and given the assessment tool - perceptions of palliative care instrument electronically. The severity of pulmonary hypertension was measured using WHO class, N-terminal pro B-type natriuretic peptide and the 6-minute walking test distance.

    RESULTS: A total of 84 patients [mean age: 35 ±11 years, female: 83.3%, median N-terminal pro B-type natriuretic peptide: 491 pg/ml (interquartile range: 155,1317.8), median 6-minute walking test distance: 420m (interquartile range: 368.5, 480m)] completed the questionnaires. Patients with a higher WHO functional class and negative feelings (r = 0.333, p = 0.004), and cognitive reaction to palliative care: hopeless (r = 0.340, p = 0.003), supported (r = 0.258, p = 0.028), disrupted (r = 0.262, p = 0.025), and perception of burden (r = 0.239, p = 0.041) are more receptive to palliative care. WHO class, N-terminal pro B-type natriuretic peptide, and 6-minute walking test distance were not associated with higher readiness for palliative care. In logistic regression analyses, patients with positive feelings (β = 2.240, p = < 0.05), and practical needs (β = 1.346, p = < 0.05), were more receptive to palliative care.

    CONCLUSIONS: Disease severity did not directly influence patients' readiness for palliative care. Patients with a positive outlook were more receptive to palliative care.

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