scholarly journals Cardiac catheterization addressing early post-operative complications in congenital heart surgery—a single-center experience

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Saud Bahaidarah ◽  
Jameel Al-Ata ◽  
Gaser Abdelmohsen ◽  
Naif Alkhushi ◽  
Mohamed Abdelsalam ◽  
...  
Keyword(s):  
Success Rate ◽  
Cardiac Catheterization ◽  
Congenital Heart ◽  
Interventional Procedures ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Ecmo Support ◽  
Single Center Experience ◽  
Post Operative Period ◽  
Inotropic Score

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).

scholarly journals Impact of Cardiac Catheterization on the Outcome of Extracorporeal Membrane Oxygenation (ECMO) After Congenital Cardiac Surgery - Two Centers Experience

2021 ◽  
Author(s):  
Gaser Abdelmohsen ◽  
Jameel Al-Ata ◽  
Naif Alkhushi ◽  
Saud Bahaidarah ◽  
Hysam Baho ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiac Catheterization ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Ecmo Support ◽  
Congenital Cardiac Surgery ◽  
Membrane Oxygenation ◽  
Successful Weaning

Abstract Background: Cardiac catheterization performed for patients supported by extracorporeal membrane oxygenation (ECMO) after congenital heart surgery may affect their clinical outcome, yet its effect in this group of patients is not adequately studied. The objective of this study was the evaluation of the impact of cardiac catheterization on successful weaning from ECMO support and survival after congenital heart surgery and determining predictors that influence successful weaning. Methods : This is a retrospective cohort study conducted on paediatric patients underwent cardiac catheterization while on ECMO support after congenital heart surgery in two cardiac centres from November 2012 till February 2020. Predictors of successful weaning from ECMO support were studied using univariable and multivariable logistic regression analysis. Results: Out of 141 patients received ECMO support after congenital cardiac surgery,60 patients underwent 60 cardiac catheterizations (31 diagnostic and 29 interventional). The median age was 6.5 months (range 4 days -20 years), median weight was 5 kg (range 2-53 kg). Thirty-four patients (56.7%) underwent successful decannulation from ECMO support and 22patients (36.3%) survived to hospital discharge. Predictors of successful weaning from ECMO support and survival were shorter duration on ECMO support, absence of bleeding tendency, early cardiac catheterization, and biventricular physiology. Conclusion: Cardiac catheterization is feasible with acceptable risks for patients receiving ECMO after congenital heart surgery. The shorter duration on ECMO support may have a significant influence on successful weaning from ECMO and survival after congenital heart surgery. Early cardiac catheterization could also influence the successful weaning from ECMO.

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

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.

scholarly journals Single center experience on dosing and adverse events of recombinant factor seven use for bleeding after congenital heart surgery

2015 ◽  
Vol 27 (1) ◽  
pp. 18-22 ◽  
Author(s):  
Mustafa Kurkluoglu ◽  
Alyson M. Engle ◽  
John P. Costello ◽  
Narutoshi Hibino ◽  
David Zurakowski ◽  
...  
Keyword(s):  
Adverse Events ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Single Center ◽  
Single Center Experience

Indications and outcomes of cardiac catheterization following congenital heart surgery in children

2021 ◽  
Vol 13 (4) ◽  
pp. 282
Author(s):  
Raymond N. Haddad ◽  
Juan Manuel Lange ◽  
Olivier Raisky ◽  
Regis Gaudin ◽  
Claudio Barbanti ◽  
...  
Keyword(s):  
Cardiac Catheterization ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery
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