Risk factors for cardiac arrhythmias in children with congenital heart disease after surgical intervention in the early postoperative period

Aim. To study the level of the N-terminal fragment of brain natriuretic peptide in children with congenital heart disease after surgical treatment and to determine its prognostic value in the postoperative period. Methods. A preoperative and postoperative examination of 113 children with congenital heart disease who were treated in the cardiac surgery department, was performed. Patients were allocated to four groups depending on the functional class of heart failure. Serum concentration of N-terminal brain natriuretic peptide fragment was determined by electrochemiluminescence before and one day after the surgery. Results. Postoperative levels of the N-terminal fragment of brain natriuretic peptide correlated with the duration of mechanical ventilation, the time that patient spends in the intensive care unit, the intensity of cardiotonic support. On the 1st day after the surgical intervention the concentration of this peptide was significantly increased in patients of the first, second and third group, by average of 7.8 times, due to the direct effect on the heart cells, surgical trauma, influence of cardioplegic solution, heart function alteration and heart failure associated with operative and post-operative period. In 24 patients of the fourth group, the N-terminal fragment of brain natriuretic peptide has significantly decreased on the first day after surgery. In 7 patients of the fourth group, the growth of the N-peptide level was reported, complicated postoperative period, sometimes with fatal outcome, took place in these cases. The level of this marker is associated with the frequency of postoperative complications, reoperations, and its threshold level for determining high-risk group for complications was 5400 pg/ml. Conclusion. The concentration of the N-terminal fragment of brain natriuretic peptide on day 1 after surgical intervention in patients with congenital heart disease can be used to predict the clinical course of postoperative period; the level above 5400 pg/ml is considered to be a risk factor for postoperative complications and reoperations.

Download Full-text

ANXIETY AND DEPRESSION IN CHILDREN AND ADOLESCENTS WITH CONGENITAL HEART DISEASE BEFORE AND AFTER SURGICAL INTERVENTION PERIOD

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v6i6.5163 ◽

2021 ◽

Vol 71 (6) ◽

pp. 2049-52

Author(s):

Kiran Azim ◽

Abdul Malik Sheikh ◽

Muhammad Masood Khokhar ◽

Asma Kanwal ◽

Touqeer Akbar ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Children And Adolescents ◽

Postoperative Period ◽

Congenital Heart ◽

Septal Defect ◽

Surgical Intervention ◽

Depression Scale ◽

Anxiety And Depression ◽

Intervention Period

Objective: To evaluate the level of anxiety and depression in children and adolescents with congenital heart disease in pre and post-surgical intervention period. Study Design: Quasi experimental study. Place and Duration of Study: Rawalpindi Institute of Cardiology, Rawalpindi Pakistan, from Jan to Dec 2019. Methodology: After written informed consent from parents and approval of hospital ethical committee 152 children and adolescents with congenital heart disease were included in the study. Demographic and clinical data was recorded on relevant proforma. In addition to clinical assessment the level of anxiety and depression were objectively measured with the help of Urdu version of Hospital Anxiety and Depression Scale by the mental health specialist a day before and 15 days after surgery. Results: The mean age of participants was 14.5 ± 3.3 years. Out of 152 participants, 80 (52.6%) were females, while 72 (47.4%) were males. Level of anxiety and depression was found higher in the preoperative period being 44 (28.9%) and 52 (34.2%) which dropped significantly in the postoperative period to 16 (10.5%) and 8 (5.3%) respectively. Majority of the patients had Tetralogy of Fallot i.e., 52 (34.2%) followed by Ventricular Septal Defect in 24 (15.7%) and Atrial Septal Defect in 18 (11.2%). Females were more likely to have depression than males (p-value=0.01). Conclusion: We found significant decrease in anxiety and depression in the postoperative period.

Download Full-text

Pulmonary Vasodilator Use in Children with Heterotaxy Syndrome Undergoing Surgical Intervention for Congenital Heart Disease

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2021.01.1288 ◽

2021 ◽

Vol 40 (4) ◽

pp. S464-S465

Author(s):

M.R. Varma ◽

M.P. McCormick ◽

D.A. Adebo ◽

M.D. Brown

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Surgical Intervention ◽

Heterotaxy Syndrome ◽

Pulmonary Vasodilator

Download Full-text

Risk Factors for Gross Motor Dysfunction in Infants With Congenital Heart Disease

Infants & Young Children ◽

10.1097/iyc.0b013e3182176274 ◽

2011 ◽

Vol 24 (3) ◽

pp. 246-258 ◽

Cited By ~ 3

Author(s):

Suzanne H. Long ◽

Bev J. Eldridge ◽

Mary P. Galea ◽

Susan R. Harris

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Motor Dysfunction ◽

Gross Motor

Download Full-text

Nineteen Years of Adult Congenital Heart Surgery in a Single Center

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135116682454 ◽

2017 ◽

Vol 8 (2) ◽

pp. 182-188

Author(s):

Madurra Perinpanayagam ◽

Signe H. Larsen ◽

Kristian Emmertsen ◽

Marianne B. Møller ◽

Vibeke E. Hjortdal

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Cardiac Surgery ◽

Heart Disease ◽

Postoperative Complications ◽

Adverse Events ◽

Congenital Heart ◽

Postoperative Bleeding ◽

Registration System ◽

Growing Population

Background: Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort. Methods: Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System. Results: Four hundred seventy-four surgeries were performed in 445 adults (50% men). The median age was 39 years (range 18-83). Thirty-nine percent had previous surgical or catheter-based interventions. Thirty-day and in-hospital mortality were 1.1%. Postoperative complications occurred in 50% of cases, most were minor such as temporary arrhythmias and pneumonia. Major complications included postoperative bleeding necessitating intervention (6%), stroke (2%), and acute temporary renal failure (1%). Multivariate analysis identified RACHS-1 categories over or equal to 3 compared to category 1 (odds ratio (OR) = 2.3; 95% confidence interval (CI): 1.5-3.7), New York Heart Association functional class III and IV compared to class I (OR = 2.2; 95% CI: 1.3-3.7) and age at surgery (OR = 1.03, 95% CI: 1.01-1.04), as risk factors for adverse events. Survival during a median follow-up of 7.8 years (range 0 days-21.4 years) was 85% (95% CI: 80%-89%). Conclusion: Adults with congenital heart disease constitute a growing population with the need for cardiac surgery. Postoperative complications are frequent but early and late mortality are low.

Download Full-text