Vista Equipo: Risk Factors for Mortality in Reoperations for Pediatric and Congenital Heart Surgery in a Developing Country

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

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 deter...

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Autores Principales:	Villa-Hincapie C.A., Carreno-Jaimes M., Obando-Lopez C.E., Camacho-Mackenzie J., Umaña-Mallarino J.P., Sandoval-Reyes N.F.
Formato:	Artículo (Article)
Lenguaje:	Inglés (English)
Publicado:	2017
Materias:	Child Colombia Developing country Epidemiology Female Follow up Heart surgery Hospital mortality Human Infant Male Mortality Newborn Preschool child Procedures Reoperation Retrospective study Risk factor Survival rate Trends Cardiac surgical procedures Developing countries Follow-up studies Humans Retrospective studies Risk factors Complications Congenital heart disease Congenital heart surgery Surgery congenital preschool newborn Heart defects
Acceso en línea:	https://repository.urosario.edu.co/handle/10336/23492 https://doi.org/10.1177/2150135117704657

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spelling	ir-10336-234922022-05-02T12:37:14Z Risk Factors for Mortality in Reoperations for Pediatric and Congenital Heart Surgery in a Developing Country Villa-Hincapie C.A. Carreno-Jaimes M. Obando-Lopez C.E. Camacho-Mackenzie J. Umaña-Mallarino J.P. Sandoval-Reyes N.F. Child Colombia Developing country Epidemiology Female Follow up Heart surgery Hospital mortality Human Infant Male Mortality Newborn Preschool child Procedures Reoperation Retrospective study Risk factor Survival rate Trends Cardiac surgical procedures Child Colombia Developing countries Female Follow-up studies Hospital mortality Humans Infant Male Reoperation Retrospective studies Risk factors Survival rate Complications Congenital heart disease Congenital heart surgery Reoperation Surgery congenital preschool newborn Heart defects Child Infant 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. 2017 2020-05-26T00:02:30Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion https://repository.urosario.edu.co/handle/10336/23492 https://doi.org/10.1177/2150135117704657 eng info:eu-repo/semantics/openAccess application/pdf instname:Universidad del Rosario
institution	EdocUR - Universidad del Rosario
collection	DSpace
language	Inglés (English)
topic	Child Colombia Developing country Epidemiology Female Follow up Heart surgery Hospital mortality Human Infant Male Mortality Newborn Preschool child Procedures Reoperation Retrospective study Risk factor Survival rate Trends Cardiac surgical procedures Child Colombia Developing countries Female Follow-up studies Hospital mortality Humans Infant Male Reoperation Retrospective studies Risk factors Survival rate Complications Congenital heart disease Congenital heart surgery Reoperation Surgery congenital preschool newborn Heart defects Child Infant
spellingShingle	Child Colombia Developing country Epidemiology Female Follow up Heart surgery Hospital mortality Human Infant Male Mortality Newborn Preschool child Procedures Reoperation Retrospective study Risk factor Survival rate Trends Cardiac surgical procedures Child Colombia Developing countries Female Follow-up studies Hospital mortality Humans Infant Male Reoperation Retrospective studies Risk factors Survival rate Complications Congenital heart disease Congenital heart surgery Reoperation Surgery congenital preschool newborn Heart defects Child Infant Villa-Hincapie C.A. Carreno-Jaimes M. Obando-Lopez C.E. Camacho-Mackenzie J. Umaña-Mallarino J.P. Sandoval-Reyes N.F. Risk Factors for Mortality in Reoperations for Pediatric and Congenital Heart Surgery in a Developing Country
description	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.
format	Artículo (Article)
author	Villa-Hincapie C.A. Carreno-Jaimes M. Obando-Lopez C.E. Camacho-Mackenzie J. Umaña-Mallarino J.P. Sandoval-Reyes N.F.
author_facet	Villa-Hincapie C.A. Carreno-Jaimes M. Obando-Lopez C.E. Camacho-Mackenzie J. Umaña-Mallarino J.P. Sandoval-Reyes N.F.
author_sort	Villa-Hincapie C.A.
title	Risk Factors for Mortality in Reoperations for Pediatric and Congenital Heart Surgery in a Developing Country
title_short	Risk Factors for Mortality in Reoperations for Pediatric and Congenital Heart Surgery in a Developing Country
title_full	Risk Factors for Mortality in Reoperations for Pediatric and Congenital Heart Surgery in a Developing Country
title_fullStr	Risk Factors for Mortality in Reoperations for Pediatric and Congenital Heart Surgery in a Developing Country
title_full_unstemmed	Risk Factors for Mortality in Reoperations for Pediatric and Congenital Heart Surgery in a Developing Country
title_sort	risk factors for mortality in reoperations for pediatric and congenital heart surgery in a developing country
publishDate	2017
url	https://repository.urosario.edu.co/handle/10336/23492 https://doi.org/10.1177/2150135117704657
_version_	1740172916619739136
score	12,131701

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

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