Outcomes of complicated congenital heart diseases following multiple re-sternotomy operations: A single-center experience
- VernacularTitle:多次手术的复杂先天性心脏病外科治疗预后的单中心分析
- Author:
Yongxuan PENG
1
,
2
,
3
;
Xinwei DU
1
,
2
,
3
;
Shunmin WANG
1
,
2
,
3
;
Jinghao ZHENG
1
,
2
,
3
;
Haibo ZHANG
1
,
2
,
3
;
Hao ZHANG
1
,
2
,
3
Author Information
1. Department of Cardiothoracic Surgery, Shanghai Children&rsquo
2. s Medical Center, National Children&rsquo
3. s Medical Center, Shanghai Institution of Pediatric Congenital Heart Disease, Medical School of Shanghai Jiao Tong University, Shanghai, 200127, P.R.China
- Publication Type:Journal Article
- Keywords:
Congenital heart disease;
re-operation;
functional single ventricle;
pulmonary atresia;
double outflow tract of right ventricle;
treatment
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(06):635-639
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the outcomes of complicated congenital heart diseases (CCHD) patients accepting multiple (>2) re-sternotomy operations. Methods We retrospectively analyzed the clinical data of 146 patients undergoing multiple cardiac re-sternotomy operations between 2015 and 2019 in our center. There were 95 males and 51 females with an age of 4.3 (3.1-6.8) years and a weight of 15.3 (13.4-19.0) kg at last operation. Results The top three cardiac malformations were pulmonary atresia (n=51, 34.9%), double outflow of right ventricle (n=36, 24.7%) and functional single ventricle (n=36, 24.7%). A total of 457 sternotomy procedures were performed, with 129 (88.3%) patients undergoing three times of operations and 17 (11.7%) patients undergoing more than three times. Fifty-two (35.6%) patients received bi-ventricular repair, 63 (43.1%) patients received Fontan-type procedures, and 31 (21.2%) patients underwent palliative procedures. Ten (6.8%) patients experienced major accidents during sternotomy, including 7 (4.8%) patients of urgent femoral artery and venous bypass. Eleven (7.5%) patients died with 10 (6.8%) deaths before discharge. The follow-up time was 20.0 (5.8-40.1) months, and 1 patient died during the follow-up. The number of operations was an independent risk factor for the death after operation. Conclusion Series operations of Fontan in functional single ventricle, repeated stenosis of pulmonary artery or conduit of right ventricular outflow tract post bi-ventricular repair are the major causes for the reoperation. Multiple operations are a huge challenge for CCHD treatment, which should be avoided.
