Risk factors for major adverse events after surgical closure of ventricular septal defect in patients less than 1 year of age: a single-center retrospective
Rev. bras. cir. cardiovasc
; 34(3): 335-343, Jun. 2019. tab
Article
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| LILACS
| ID: biblio-1013465
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BR1.1
ABSTRACT
Abstract Objective:
To reveal the risk factors that can lead to a complicated course and an increased morbidity in patients < 1 year old after surgical ventricular septal defect (VSD) closure.Methods:
We reviewed a consecutive series of patients who were admitted to our institution for surgical VSD closure who were under one year of age, between 2015 and 2018. Mechanical ventilation (MV) time > 24 hours, intensive care unit (ICU) stay longer than three days, and hospital stay longer than seven days were defined as "prolonged". Unplanned reoperation, complete heart block requiring a permanent pacemaker implantation, sudden circulatory arrest, and death were considered as significant major adverse events (MAE).Results:
VSD closure was performed in 185 patients. The median age was five (1-12) months. There was prolonged MV time in 54 (29.2%) patients. Four patients (2.2%) required permanent pacemaker implantation. Hemodynamically significant residual VSD was observed in six (3.2%) patients. Extracorporeal membrane oxygenation-cardiopulmonary resuscitation was performed in one (0.5%) patient. Small age (< 4 months) (P-value<0.001) and prolonged cardiopulmonary bypass time (P=0.03) were found to delay extubation and to prolong MV time. Low birth weight at the operation was associated with MAE (P=0.03).Conclusion:
Higher body weight during operation had a reducing effect on the MAE frequency and shortened the MV duration, ICU stay, and hospital stay. As a conclusion, for patients who are scheduled to undergo VSD closure, body weight should be taken into consideration.Palavras-chave
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Índice:
LILACS
Assunto principal:
Complicações Pós-Operatórias
/
Técnicas de Fechamento de Ferimentos
/
Comunicação Interventricular
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
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Infant
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Male
/
Pregnancy
Idioma:
En
Revista:
Rev. bras. cir. cardiovasc
Assunto da revista:
CARDIOLOGIA
/
CIRURGIA GERAL
Ano de publicação:
2019
Tipo de documento:
Article