P0325 / #420: CATHETERIZATION IN THE EARLY POST-OPERATIVE PERIOD AFTER CONGENITAL HEART SURGERY IN CHILDREN: A SINGLE-CENTER EXPERIENCE IN MEXICO

Abstract Background Cardiac catheterization after congenital heart surgery may play an important role in the diagnosis and management of patients with a complicated or unusual post-operative course. The main objective of this study was to evaluate the safety, efficacy, and outcome of cardiac catheterization performed in the early post-operative period following congenital heart surgery. All patients who underwent cardiac catheterization after congenital heart surgery during the same admission of cardiac surgery from November 2015 to May 2018 were included in the study. Results Thirty procedures were performed for 27 patients (20 interventional and 10 diagnostic). The median age of the patients was 15 months (15 days to 20 years), median weight was 8.2 kg (3.4 to 53 kg), and median time from surgery was 3 days (0–32 days). Eleven procedures were performed for 11 patients on extracorporeal membrane oxygenation (ECMO) support. The main indications for catheterization included the inability to wean from ECMO (10 procedures) and cyanosis (10 procedures). Interventional procedures included angioplasty using stents (10 procedures, success rate of 90%), angioplasty using only balloons (2 procedures, success rate of 50%), and occlusion for residual shunts (8 procedures, success rate of 100%). No mortality was recorded during any procedure. Vasoactive–inotropic score had significantly decreased 48 h after catheterization when compared to pre-catheterization scores (p = 0.0001). Moreover, 72% of patients connected to ECMO support were successfully weaned from ECMO after catheterization. Procedural complications were recorded in 3 interventional procedures. Survival to hospital discharge was 55.5% and overall survival was 52%. Patients on ECMO support had a higher mortality than other patients. Conclusion Cardiac catheterization can be performed safely in the early post-operative period, and it could improve the outcome of the patient (depending on the complexity of the cardiac lesions involved).

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Practice Patterns in Postoperative Echocardiographic Surveillance after Congenital Heart Surgery in Children: A Single Center Experience

The Journal of Pediatrics ◽

10.1016/j.jpeds.2016.09.061 ◽

2017 ◽

Vol 180 ◽

pp. 87-91.e1 ◽

Cited By ~ 1

Author(s):

Alisa Arunamata ◽

David M. Axelrod ◽

Alaina K. Kipps ◽

Doff B. McElhinney ◽

Andrew Y. Shin ◽

...

Keyword(s):

Congenital Heart ◽

Heart Surgery ◽

Practice Patterns ◽

Congenital Heart Surgery ◽

Single Center ◽

Single Center Experience

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Single-Center Experience with the Matrix Patch and Its Application in Congenital Heart Surgery

10.1055/s-0039-1678840 ◽

2019 ◽

Author(s):

A. Schulz ◽

S. Ozaki ◽

P. Murin ◽

M.-Y. Cho ◽

M. Musci ◽

...

Keyword(s):

Congenital Heart ◽

Heart Surgery ◽

Congenital Heart Surgery ◽

Single Center ◽

Single Center Experience ◽

The Matrix ◽

Matrix Patch

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Post-operative kinetics of C-reactive protein to distinguish between bacterial infection and systemic inflammation in infants after cardiopulmonary bypass surgery: the early and the late period

Cardiology in the Young ◽

10.1017/s1047951121003231 ◽

2021 ◽

pp. 1-8

Author(s):

Hanna Renk ◽

David Grosse ◽

Sarah Schober ◽

Christian Schlensak ◽

Michael Hofbeck ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Bacterial Infection ◽

Congenital Heart ◽

Bypass Surgery ◽

Heart Surgery ◽

Congenital Heart Surgery ◽

C Reactive Protein ◽

Reactive Protein ◽

Post Operative Period ◽

Kinetics Of

Abstract Objectives: Differentiation between post-operative inflammation and bacterial infection remains an important issue in infants following congenital heart surgery. We primarily assessed kinetics and predictive value of C-reactive protein for bacterial infection in the early (days 0–4) and late (days 5–28) period after cardiopulmonary bypass surgery. Secondary objectives were frequency, type, and timing of post-operative infection related to the risk adjustment for congenital heart surgery score. Methods: This 3-year single-centre retrospective cohort study in a paediatric cardiac ICU analysed 191 infants accounting for 235 episodes of CPBP surgery. Primary outcome was kinetics of CRP in the first 28 days after CPBP surgery in infected and non-infected patients. Results: We observed 22 infectious episodes in the early and 34 in the late post-operative period. CRP kinetics in the early post-operative period did not accurately differentiate between infected and non-infected patients. In the late post-operative period, infected infants displayed significantly higher CRP values with a median of 7.91 (1.64–22.02) and 6.92 mg/dl (1.92–19.65) on days 2 and 3 compared to 4.02 (1.99–15.9) and 3.72 mg/dl (1.08–9.72) in the non-infection group. Combining CRP on days 2 and 3 after suspicion of infection revealed a cut-off of 9.47 mg/L with an acceptable predictive accuracy of 76%. Conclusions: In neonates and infants, CRP kinetics is not useful to predict infection in the first 72 hours after CPBP surgery due to the inflammatory response. However, in the late post-operative period, CRP is a valuable adjunctive diagnostic test in conjunction with clinical presentation and microbiological diagnostics.

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