Pediatric Cardiac Surgery Complications and the Risk Factors: A Single-Center Study

Mohammadreza Mirzaaghayan; Zahra Vahdati; Hossein Nematian; Sara Memarian; Morteza Heidari; Mohammad Hossein Askari; Behdad Gharib

doi:10.18502/jthc.v19i2.16202

Mohammadreza Mirzaaghayan Department of General Surgery, School of Medicine, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Zahra Vahdati School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Hossein Nematian School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Sara Memarian Department of Pediatrics, School of Medicine, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Morteza Heidari Department of Pediatrics, School of Medicine, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Hossein Askari Tehran University of Medical Sciences, Children's Medical Center, Tehran, Iran.
Behdad Gharib Department of Pediatrics, School of Medicine, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jthc.v19i2.16202

Keywords: Cardiovascular diseases; Heart defects, congenital

Abstract

Background: This study aimed to determine postoperative cardiac and noncardiac complications and their association with the use of cardiopulmonary bypass (CPB), surgical outcomes (length of hospital and ICU stays), dependence on mechanical ventilation, and mortality.

Methods: This retrospective cross-sectional study was conducted on pediatric patients aged 0 to 18 who underwent open or closed cardiac surgery over a 1-year period. The use of CPB support, CPB duration, cardiac surgery complexity according to the risk-adjusted classification for congenital heart surgery (RACHS-1), and demographics were examined as potential risk factors associated with an increased number of postoperative complications. The study was performed at the Children’s Medical Center, a teaching hospital affiliated with Tehran University of Medical Sciences in Iran.

Results: A total of 283 surgeries were included in our study. Seventy-six (26.9%) of the study population experienced at least 1 complication. Our analysis revealed that increased CPB durations were associated with higher odds of cardiac complications, with an odds ratio of 1.02 (P=0.002). Moreover, higher RACHS-1 levels were significantly associated with greater numbers of cardiac and noncardiac complications. Additionally, prolonged mechanical ventilation and open-heart surgery intensive care unit (OH-ICU) stays were significantly associated with cardiac and noncardiac complications. Our logistic regression analysis found no association between demographic and clinical risk factors, the number of complications, and mortality.

Conclusion: Postoperative complications occurred in 27% of pediatric heart surgeries. Prolonged mechanical ventilation and OH-ICU stays were significantly associated with cardiac and noncardiac complications. However, no significant association was found between postoperative complications and mortality.