2021
DOI: 10.1177/21501351211037624
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Risk of Pediatric Cardiac Surgery Increased in Patients Undergoing Tracheal Surgery During the Same Hospitalization

Abstract: Background The impact of complex tracheal surgery (TS) on outcomes of children undergoing cardiac surgery has rarely been investigated in large national databases and could impact anticipated outcomes in those patients. Methods The Pediatric Health Information System database was reviewed from January 1, 2005 to December 31, 2014, for pediatric (<18 years) patients undergoing select cardiac surgical procedures using International Classification of Disease-9 procedural coding. Patients were divided based upo… Show more

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“…Operative survival ranges from 84 to 95% in larger series, although mortality as high as 30% is reported. The authors hypothesized that surgical repair of congenital tracheal anomalies and congenital heart disease (CHD) during the same hospitalization may still be associated with increased surgical risk [ 6 ].…”
Section: Risk Of Pediatric Cardiac Surgery Increased In Patients Undergoing Tracheal Surgery During the Same Hospitalizationmentioning
confidence: 99%
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“…Operative survival ranges from 84 to 95% in larger series, although mortality as high as 30% is reported. The authors hypothesized that surgical repair of congenital tracheal anomalies and congenital heart disease (CHD) during the same hospitalization may still be associated with increased surgical risk [ 6 ].…”
Section: Risk Of Pediatric Cardiac Surgery Increased In Patients Undergoing Tracheal Surgery During the Same Hospitalizationmentioning
confidence: 99%
“…57 patients (14%) with the composite outcome (46 death, 7 heart transplant and 4 heart transplant listing) Elevated ventricular end diastolic volume (EDVi) was the strongest risk factor for the composite outcome with a threshold above 156 ml/BSA 1.3 Ventricular dilation by CMR was the strongest predictor of worse outcomes along with other risk factors including worse circumferential strain, worse functional status, and worse global function index Liu et al The Fate of Congenitally Corrected Transposition of the Great Arteries (ccTGA) Unoperated Before Adulthood [ 4 ] The outcomes, therapeutic strategies, and risk factors associated with ccTGA combined with associated cardiac lesions remain unclear 117 patients over a span of 9 years 3 groups: IVS, VSD and PS The PS groups had significantly less systemic AVV regurgitation and ventricular dysfunction and highest systemic ventricle ejection fraction 49 patients underwent surgery with no hospital mortality IVS group: patients receiving systemic atrioventricular valve replacement/ valvuloplasty had a significantly increased systemic ventricular ejection fraction and statistically more freedom from death and transplant than unoperated VSD group: late systemic ventricular ejection fraction of operated patients was not statistically different PS group: had significantly decreased systemic ventricular ejection fraction PS protects against systemic atrioventricular valve regurgitation and ventricular dysfunction Physiologic repair was not ideal for ccTGA with PS. Severe systemic atrioventricular valve regurgitation and systemic ventricular dysfunction were associated with suboptimal outcomes Onan et al Early Results of Robotically Assisted Congenital Cardiac Surgery: Analysis of 242 Patients [ 5 ] 242 patients underwent robotic surgery from 2013–2020 Most common defect: secundum ASD, 74.7%; sinus venosus ASD 16%, PAPVC10.7% No mortality Operative complications included aortic laceration, aortic bleeding, pleural bleeding, injury to SVC, left atrial appendage and femoral artery Ventilation time, intensive care unit stay, and the length of hospital stay were 5.2 + / − 2.9 h, 16.8 + / − 2.5 h, and 3.5 + / − 1.1 days, respectively Postoperative rates of stroke, cardiac events, pulmonary complications, and reexploration were 0.4%, 2.4%, 4.1%, and 0.8%, respectively Robotic technology can be utilized to perform suitable congenital operations safely and effectively albeit there is a learning curve Riggs et al Risk of Pediatric Cardiac Surgery Increased in Patients Undergoing Tracheal Surgery During the Same Hospitalization [ 6 ] Most common airway anomaly: congenital tracheal stenosis, tracheoesophageal fistula PHIS database, < 18 years old, 2005–2014 2 groups: CHS + TS, CHS alone propensity matched 2:1 Total number of patients 46,497, 283 in CHS + TS and 566 in CHS only group CHS + TS – increased mechanical ventilation, acute kidney injury, total parenteral nutrition Hospital mortality 13.8% for CHS + TS, 5.8% for CHS group Surgical complications 59% CHS + TS, 43% CHS group MV analysis risk factors for mortality: TS, ECMO, acute kidney injury, TPN The authors concl...…”
Section: Risk Of Pediatric Cardiac Surgery Increased In Patients Undergoing Tracheal Surgery During the Same Hospitalizationmentioning
confidence: 99%
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