P0337 / #910: PREDICTIVE MARKERS OF MORTALITY AND MORBIDITY IN THE POSTOPERATIVE PERIOD OF CONGENITAL HEART SURGERY

Introduction. Total anomalous pulmonary venous connection (TAPVC) is a rare congenital heart disease and in some variants represents the only true surgical emergency in congenital heart surgery. Basic anatomical characteristic of this anomaly is an abnormal connection of pulmonary veins with systemic venous circulation. Although the results of TAPVC repair in infancy have been markedly improved in recent years, the recurrent pulmonary venous obstruction (RPVO) remains relatively frequent complication of surgical treatment. Objective. The aim of this study was a retrospective evaluation of TAPVC repair at a single institution, identifying the risk factors associated with the increased mortality and morbidity. Methods. Between January 2001 and January 2010, 43 consecutive patients underwent repair of TAPVC at the University Children?s Hospital, with median weight of 3.8 kg (1.8-13 kg). Median age at surgery varied from 5 days to 5 years. Distribution of TAPVC types was as follows: supracardiac 19 (44%), cardiac 12 (28%), infracardiac 9 (21%), and mixed 3 (7%). Eleven patients (26%) were emergencies due to obstructed drainage. Results. Early mortality was 9.30% (4/43). An average time of followup/survival for 95% interval of confidence was 101.6?6.7 months. Kaplan-Meier cumulative survival was 83.7?5.7%. Freedom from reintervention after 10 years was 87.2?0.5%. The principal reason for reintervention was RPVO. Conclusion. Preoperative obstruction is not a risk factor of early mortality and RPVO. Low body mass (below 2.5 kg) is the only identified risk factor of early mortality. Complex morphology of the confluens, particularly in a mixed type of TAPVR, is the main risk factor of RPVO development.

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Catheterization Performed in the Early Postoperative Period After Congenital Heart Surgery in Children

Pediatric Cardiology ◽

10.1007/s00246-019-02078-3 ◽

2019 ◽

Vol 40 (4) ◽

pp. 827-833

Author(s):

Ana María Eraso-Díaz del Castillo ◽

María Clara Escobar-Díaz ◽

Rafael Lince Varela ◽

Luis Horacio Díaz Medina ◽

Eliana Mabel Cañas Arenas

Keyword(s):

Postoperative Period ◽

Congenital Heart ◽

Heart Surgery ◽

Congenital Heart Surgery ◽

Early Postoperative Period

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Status of cardiovascular surgery in Japan: a report based on the Japan Cardiovascular Surgery Database 2017–2018. 1. Congenital heart surgery

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492320981501 ◽

2020 ◽

pp. 021849232098150

Author(s):

Yasutaka Hirata ◽

Norimichi Hirahara ◽

Arata Murakami ◽

Noboru Motomura ◽

Hiroaki Miyata ◽

...

Keyword(s):

European Association ◽

Congenital Heart ◽

Heart Surgery ◽

Cardiovascular Surgery ◽

Mortality Rates ◽

Congenital Heart Surgery ◽

Mortality And Morbidity ◽

Defect Repair ◽

Surgery Mortality ◽

Anomalous Pulmonary Venous Connection

Objectives We aimed to analyze the mortality and morbidity associated with congenital heart surgery in Japan. Methods Data on congenital heart surgeries performed between January 2017 and December 2018 were obtained from Japan Cardiovascular Surgery Database. The 20 most frequent procedures were selected, and mortalities and major morbidities associated with the procedures were analyzed. All procedures were classified into Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart Surgery mortality categories, and mortalities in each category were also analyzed. Results The mortality rates in atrial septal defect repair and ventricular septal repair were 0% and 0.2%, respectively. The mortality rates in more complex cases (tetralogy of Fallot repair, complete atrioventricular repair, bidirectional Glenn, and total cavopulmonary connection) were 2%–3%. The mortality rates in systemic-to-pulmonary shunt, total anomalous pulmonary venous connection repair, and the Norwood procedure were 4.9%, 11.1%, and 15.7%, respectively, which were not different from those reported in 2015–2016. The mortalities according to the Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery categories 1–5 were 0.3%, 2.7%, 2.9%, 5.9%, and 15.5%, respectively, and comparable to those of the Society of Thoracic Surgeons database (2013–2016). Conclusion The mortality rates and frequency of complications in major surgical procedures for congenital heart disease in Japan in 2017–2018 will play an important role as a basis for trends in Japan and for comparison with results from other countries.

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