Korean J Pediatr.
2010 Apr;53(4):532-537. 10.3345/kjp.2010.53.4.532.
Early postoperative arrhythmias after open heart surgery of pediatric congenital heart disease
- Affiliations
-
- 1Department of Pediatrics, Kumi-Cha hospital, CHA University School of Medicine, Korea.
- 2Department of Pediatrics, College of Medicine, Keimyung University, Daegu, Korea.
- 3Department of Thoracic and Cardiovascular Surgery, College of Medicine, Kyungpook National University, Daegu, Korea.
- 4Department of Pediatrics, College of Medicine, Kyungpook National University, Daegu, Korea. mchyun@knu.ac.kr
- KMID: 2073579
- DOI: http://doi.org/10.3345/kjp.2010.53.4.532
Abstract
- PURPOSE
Early postoperative arrhythmias are a major cause of mortality and morbidity after open heart surgery in the pediatric population. We evaluated the incidence and risk factors of early postoperative arrhythmias after surgery of congenital heart disease.
METHODS
From January 2002 to December 2008, we retrospectively reviewed the medical records of the 561 patients who underwent cardiac surgery in Kyungpook National University Hospital. We analyzed patients' age and weight, occurrence and type of arrhythmia, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time, and postoperative electrolyte levels.
RESULTS
Arrhythmias occurred in 42 of 578 (7.3%) cases of the pediatric cardiac surgery. The most common types of arrhythmia were junctional ectopic tachycardia (JET) and accelerated idioventricular rhythm (AIVR), which occurred in 17 and 13 cases, respectively. The arterial switch operation (ASO) of transposition of the great arteries (TGA) had the highest incidence of arrhythmia (36.4%). Most cases of cardiac arrhythmia showed good response to management. Patients with early postoperative arrhythmias had significantly lower body weight, younger age, and prolonged CPB and ACC times (P<0.05) than patients without arrhythmia. Although the mean duration of ventilator care and intensive care unit stay were significantly longer (P<0.05), the mortality rate was not significantly different among the 2 groups.
CONCLUSION
Early postoperative arrhythmias are a major complication after pediatric cardiac surgery; however, aggressive and immediate management can reduce mortality and morbidity.
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