scholarly journals Microbiology of Post-Cardiac Surgery Infections in Children with Congenital Heart Diseases, A Single-Center Experience, Mashhad, Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Behzad Alizadeh ◽  
Ghasem Dolatkhah ◽  
Hossein Akhavan ◽  
Hasan Birjandi ◽  
Mohammad Reza Naghibi Sistani ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Nosocomial Infections ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Pediatric Patients ◽  
Heart Diseases ◽  
Urinary Catheterization ◽  
Post Cardiac Surgery

Background: Children who have undergone cardiac surgeries due to congenital heart disease are prone to various kinds of infections. Objectives: This study was done to investigate the prevalence of nosocomial infections and microbiology of post-cardiac surgery infections in pediatric patients with congenital heart disease (CHD). Methods: In this cross-sectional study, the epidemiology and microbiology of post-cardiac surgery for pediatric patients with CHD at Imam Reza Hospital of Mashhad University of Medical Sciences between 2014 and 2017 were investigated. Demographic and clinical information was recorded, and the findings were analyzed using SPSS 16. Results: Out of 1128 patients with open heart surgery during the four years of the study, 135 patients, including 80 males (60.1%) and 55 females (39.9%) with a mean age of 8.06 ± 3.86 months, were enrolled in the study. The prevalence of infection was 11.96%. The most common isolated bacteria were Acinetobacter (19/135, 14.1%), Pseudomonas spp. (13/135, 9.6%), and Enterobacter (13/135, 9.6%) as Gram-negative ones and Corynebacterium diphtheria (10/135, 7.4%) and Staphylococcus epidermidis (10/135, 7.4%) as Gram-positive types. Candida albicans (14/135, 10.4%) were also the most frequent fungi. The frequency of infection-causing masses did not differ significantly between different cardiac abnormalities (P = 0.831), sex (P = 0.621), age (P = 0.571), and weight (P = 0.786) groups. Also, the duration of hospitalization, intubation, bypass time, and urinary catheterization in positive culture cases were significantly longer than in negative cases. Conclusions: In our study, the most common infections in children who underwent heart surgery were Acinetobacter, C. albicans, Pseudomonas, and Enterobacter. It is suggested to reduce the hospitalization, intubation, bypass, and urinary catheterization time to reduce nosocomial infections in these patients and decrease treatment costs.

Incidence, risk factors, and outcomes of acute kidney injury in adults undergoing surgery for congenital heart disease

2016 ◽  
Vol 27 (6) ◽  
pp. 1068-1075 ◽  
Author(s):  
David M. Kwiatkowski ◽  
Elizabeth Price ◽  
David M. Axelrod ◽  
Anitra W. Romfh ◽  
Brian S. Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Kidney Injury ◽  
Congenital Heart Surgery ◽  
Left Ventricular

AbstractBackgroundAcute kidney injury after cardiac surgery is a frequent and serious complication among children with congenital heart disease (CHD) and adults with acquired heart disease; however, the significance of kidney injury in adults after congenital heart surgery is unknown. The primary objective of this study was to determine the incidence of acute kidney injury after surgery for adult CHD. Secondary objectives included determination of risk factors and associations with clinical outcomes.MethodsThis single-centre, retrospective cohort study was performed in a quaternary cardiovascular ICU in a paediatric hospital including all consecutive patients ⩾18 years between 2010 and 2013.ResultsData from 118 patients with a median age of 29 years undergoing cardiac surgery were analysed. Using Kidney Disease: Improving Global Outcome creatinine criteria, 36% of patients developed kidney injury, with 5% being moderate to severe (stage 2/3). Among higher-complexity surgeries, incidence was 59%. Age ⩾35 years, preoperative left ventricular dysfunction, preoperative arrhythmia, longer bypass time, higher Risk Adjustment for Congenital Heart Surgery-1 category, and perioperative vancomycin use were significant risk factors for kidney injury development. In multivariable analysis, age ⩾35 years and vancomycin use were significant predictors. Those with kidney injury were more likely to have prolonged duration of mechanical ventilation and cardiovascular ICU stay in the univariable regression analysis.ConclusionsWe demonstrated that acute kidney injury is a frequent complication in adults after surgery for CHD and is associated with poor outcomes. Risk factors for development were identified but largely not modifiable. Further investigation within this cohort is necessary to better understand the problem of kidney injury.

scholarly journals The treatment of pectus carinatum with the bracing after surgery for congenital heart disease: experience from a single institution

2021 ◽  
Author(s):  
De-rong He ◽  
Jing-jing Zha ◽  
Song-ming Hong ◽  
Jun-jie Hong ◽  
Jin-xi Huang ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Retrospective Study ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Pediatric Patients ◽  
Median Sternotomy ◽  
Attractive Alternative ◽  
Pectus Carinatum ◽  
Stage 1

Abstract Purpose:Secondary pectus carinatum (PC) after surgery for congenital heart disease(CHD) has its own clinical characteristics.Conservative treatment of PC with bracing is an attractive alternative to surgical repair.This study was to investigate the effects of the bracing on treating pediatric patients with PC after heart surgery.Methods:We conducted a retrospective study of all patients who had PC after surgery for CHD with median sternotomy from March 2019 to December 2020.Monthly follow-up with anterior–posterior(AP) width measurements.The size of bracing is designed based on the patient’s anterior chest wall.Result:Twenty four patients (3/2019–12/2020) were conducted into this retrospective study in the clinic,and 22 patients(91.66%) achieved excellent correction.The twenty four patients were distributed into three stages(stage 1: treated for 0 month,stage 2:treated for 3 months, stage 3: treated for 6 months).We found statistically significant differences in the AP between stage 2 and stage 1(AP p<0.01),stage 3 and stage 2(AP p<0.01).The main side effects were mild subcutaneous hematoma,petechial bleeding and chest tightness.There was no children complicated with hydropericardium or cardiac tamponade.Conclusion:The bracing has been shown to be a safe and effective approach for the treatment of the pediatric patients with PC after surgery for CHD.

scholarly journals Down’s Syndrome with Congenital Heart Disease: Our Surgical Experience

2020 ◽  
Vol 13 (1) ◽  
pp. 35-39
Author(s):  
Md Zahidul Islam ◽  
Sakila Israt Jahan ◽  
Shahriar Moinuddin ◽  
Khondokar Shamim Shahriar Ziban Rushel ◽  
Shafiqul Islam ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Surgical Correction ◽  
Pace Maker

Background: Our objective was to analyze the outcome of patients of Down’s syndrome with congenital heart diseases undergoing cardiac surgery. Methods: This was a retrospective study conducted between January 2013 and June 2019. 49 consecutive patients with Down’s syndrome with congenital heart disease admitted in pediatric cardiac surgery unit at National Institute of Cardiovascular Diseases (NICVD). Patients were followed up postoperatively for in-hospital outcome. Results: Among 49 patients the heart lesion ranked in incidence as follows- VSD 24(48.97%), AV canal defect 12(24.48%), TOF 6(12.24%), PDA 6(12.24%) and ASD 1(2.04%). Pulmonary hypertension was found in 63.25% patients. Moderate pulmonary hypertension was most common, found in 18(38.66%) patients. Severe and mild pulmonary hypertension was found in 10(32.38%) and 3(9.67%) patients respectively. All the patients had undergone surgical correction. The postoperative period was complicated in 44.89% of patients. The most frequent complication was pulmonary infection 20.40%, Wound infection 6.12% and low output syndrome 6.12% were the next. One patient had postoperative heart block, needed permanent pace maker implantation. In-hospital mortality was 12.24%. Conclusion: Patients with Down’s syndrome with congenital heart disease undergoing surgical correction had an acceptable postoperative morbidities and mortality. Cardiovasc. j. 2020; 13(1): 35-39

scholarly journals Risk Factors for Mortality in Reoperations for Pediatric and Congenital Heart Surgery in a Developing Country

2017 ◽  
Vol 8 (4) ◽  
pp. 435-439 ◽  
Author(s):  
Carlos A. Villa-Hincapie ◽  
Marisol Carreno-Jaimes ◽  
Carlos E. Obando-Lopez ◽  
Jaime Camacho-Mackenzie ◽  
Juan P. Umaña-Mallarino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Operative Mortality ◽  
Congenital Heart Surgery ◽  
Pediatric Cardiac Surgery ◽  
Cross Clamp Time

Background: The survival of patients with congenital heart disease has increased in the recent years, because of enhanced diagnostic capabilities, better surgical techniques, and improved perioperative care. Many patients will require reoperation as part of staged procedures or to treat grafts deterioration and residual or recurrent lesions. Reoperations favor the formation of cardiac adhesions and consequently increase surgery time; however, the impact on morbidity and operative mortality is certain. The objective of the study was to describe the risk factors for mortality in pediatric patients undergoing a reoperation for congenital heart disease. Methods: Historic cohort of patients who underwent reoperation after pediatric cardiac surgery from January 2009 to December 2015. Operations with previous surgical approach different to sternotomy were excluded from the analysis. Results: In seven years, 3,086 surgeries were performed, 481 were reoperations, and 238 patients fulfilled the inclusion criteria. Mean number of prior surgeries was 1.4 ± 0.6. Median age at the time of reoperation was 6.4 years. The most common surgical procedures were staged palliation for functionally univentricular heart (17.6%). Median cross-clamp time was 66 minutes. Younger age at the moment of resternotomy, longer cross-clamp time, and Society of Thoracic Surgeons–European Association for Cardio-Thoracic Surgery Congenital Heart Surgery (STAT) Mortality Categories risk category greater than three were risk factors for mortality. The number of resternotomies was not associated with mortality. Mortality prior to hospital discharge was 4.6%, and mortality after discharge but prior to 30 days after surgery was 0.54%. Operative mortality was 5.1%. Conclusions: Resternotomy in pediatric cardiac surgery is a safe procedure in our center.

The Conservative Tradition in British Thoracic and Cardiac Surgery 1900–1956

2018 ◽  
Vol 33 (3) ◽  
pp. 749-771
Author(s):  
Christopher Lawrence
Keyword(s):  
Twentieth Century ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Hospital Medicine ◽  
Surgical Research ◽  
Traditional Values ◽  
Post War

Summary Guy’s Hospital was a major setting for the creation of heart surgery as a practice and speciality in immediate post-war Britain. Medical reformers of the twentieth century characterised much London hospital medicine as conservative and not organised for the production of modern research. Through the minutes of a hospital club formed to manage congenital heart disease, the paper explores how dynamic surgical research was carried out in an institution committed to traditional values and organisation. I trace the background to this development from around 1900.

scholarly journals Risk factors for nosocomial infections after cardiac surgery in newborns with congenital heart disease

2018 ◽  
Vol 59 (4) ◽  
pp. 404-409 ◽  
Author(s):  
Heladia García ◽  
Beatriz Cervantes-Luna ◽  
Héctor González-Cabello ◽  
Guadalupe Miranda-Novales
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Nosocomial Infections ◽  
Congenital Heart
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