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Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.

2023, Number 3

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Cir Card Mex 2023; 8 (3)

Risk factors for low cardiac output syndrome after congenital heart surgery

Loredo-Medina J, Celis-Jasso JS, Saldaña-Becerra MA, Castro-Roblina LE

Language: English
References: 28
Page: 64-69
PDF size: 126.60 Kb.


ABSTRACT

Background. Congenital Heart Disease (CHD) is the most frequent malformation at birth. Although Mexico does not have accurate statistics, the prevalence is estimated at 8 per 1,000 live births. Additionally, 5 to 20% of the patients will present heart failure, increasing even more after a surgical procedure. Objective. Identify risk factors for heart failure after congenital heart disease surgery in which Del Nido cardioplegia was used. Material. Longitudinal and observational study. Patients admitted to the intensive pediatric cardiovascular unit after cardiac surgery from January to August 2021 were included. Low cardiac output syndrome was diagnosed by clinical, echocardiographic and blood gas parameters. Results. Sixty-nine patients were included; the median age was 9 months, 60.9% were male, and the most frequent surgical risk was RACHS 2 and 3 (50.8 and 27%, respectively); 92% of the patient had biventricular physiology. The most frequent diagnoses were ventricular septal defect (VSD) (30.4%) and Tetralogy of Fallot (TOF) (13%). Cardiopulmonary bypass (CPB) and aortic cross-clamping times were 111.58 minutes ± 53.74 minutes and 64.87 minutes ± 34.99 minutes, respectively. The identify risk factors were preoperative characteristics, age, weight, and height (p ‹0.05); intraoperative risk factors, CBP, aortic cross-clamping, selective cerebral perfusion, minimum temperature, and maximum lactate (p‹ 0.05); postoperative factor, arrhythmias (OR 13.6; 95%CI 3.741 - 49.801; p=0.000). Low cardiac output syndrome (LCOS) increased mortality (OR 2.3; 95%CI 1.270 - 2.304; p=0.005). Conclusions. LCOS was present in 49.3% of the patients with a 2.3- fold increase in mortality. We identified several risk factors and documented a 14.3% mortality rate.


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