Objective
To analyze data related to surgical treatment in patients with congenital
heart defects (CHD) and Down syndrome (DS) based on information from
International Quality Improvement Collaborative Database for Congenital
Heart Disease (IQIC).
Methods
Between July 1, 2010 and December 31, 2017, 139 patients with CHD and DS
underwent surgery at Hospital de Base and Hospital da Criança e
Maternidade de São José do Rio Preto (FUNFARME)/Faculdade de
Medicina de São José do Rio Preto - SP (FAMERP). A
quantitative, observational and cross-sectional study was performed in which
the pre, intra and postoperative data were analyzed in an IQIC database. The
data included gender, age, prematurity, weight, preoperative procedures,
diagnosis, associated cardiac and non-cardiac anomalies, Risk Adjustment for
Congenital Heart Surgery (RACHS-1), type of surgery, cardiopulmonary bypass
(CPB), perfusion time, aortic clamping time and CPB temperature, bacterial
sepsis, surgical site infection and other infections, length of stay in
intensive care unit (ICU), length of hospital stay and in-hospital
mortality.
Results
The most prevalent procedures were complete atrioventricular septal defect
repair (58 - 39.45%), followed by closure of ventricular septal defect (36 -
24.49%). The RACHS-1 categories 1, 2, 3 and 4 were distributed as 22 (15%);
49 (33.3%); 72 (49%) and 4 (2.7%), respectively. There were no procedures
classified as categories 5 or 6. Bacterial sepsis occurred in 10.2% of
cases, surgical site infection in 6.1%, other infections in 14.3%. The
median length of ICU stay was 5 days and the median length of hospital stay
was 11 days. In-hospital mortality was 6.8%.
Conclusion
Surgical treatment in patients with CHD and DS usually does not require
highly complex surgical procedures, but are affected by infectious
complications, resulting in a longer ICU and hospital length of stay with
considerable mortality.
