Causes of early death in children after congenital heart surgery / 中国小儿急救医学

ABSTRACT

Objective:To explore the causes of death after congenital heart surgery, which may be benefit for improving postoperative outcome of children with congenital heart disease (CHD).Methods:All cases of in-hospital mortality from 2013 to 2018 were collected to analyze the epidemiological characteristics of mortality and causes of death.Results:The mortality showed a downtrend over the past 6 years, from 2.2% in 2013 to 1.2% in 2018.Of all the cases, 72.0% children died under the age of one year old.The death mainly occurred within one week postoperatively (254, 73.2%), especially during the first (101, 29.1%) and the second (51, 14.7%) days.The main cause of death was residual or remained anatomy issues (103, 29.7%), followed by arrhythmia (66, 19.0%) and pulmonary hypertension (57, 16.4%). The incidence of heart failure ( P=0.048) and pulmonary hypertension( P<0.001) in children with functional single ventricle was higher than that in biventricular patients. Conclusion:With the progress of surgical technology and cardiopulmonary bypass, and the improvement of postoperative management, early death after the open-heart surgery for CHD decreased year by year.Postoperative residual or remained anatomy issues was the main cause of death, and the management of it should be strengthened in clinic, especially in children under one year old.