Risk Factors for Early Post-Operative Arrhythmias in Children Undergoing  Congenital Heart Surgeries

Mujeeb ur Rehman; Muhammad Asif Khan; Raam Chand; Shahnawaz Sathio; Abdul Sattar Shaikh; Fatima Amin; Najma Patel

doi:10.51253/pafmj.v74i4.7894

Authors

Mujeeb ur Rehman Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases Karachi Pakistan
Muhammad Asif Khan Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases Karachi Pakistan
Raam Chand Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases Sukkur Pakistan
Shahnawaz Sathio Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases Hyderabad Pakistan
Abdul Sattar Shaikh Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases Karachi Pakistan
Fatima Amin Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases Karachi Pakistan
Najma Patel Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases Karachi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i4.7894

Keywords:

Arrhythmia, cardiopulmonary bypass, inotropic score, left ventricular ejection fraction

Abstract

Objective: To determine the risk factors for early post-operative arrhythmias in children undergoing congenital heart surgeries at a tertiary care hospital.

Study Design: Prospective longitudinal study.

Place and Duration of Study: National Institute of Cardiovascular Disease, Karachi Pakistan, from Jan to Jul 2020.

Methodology: We included 143 patients of both genders undergoing open heart surgery for congenital heart diseases. We noted all patients' pre-operative, intra-operative, and post-operative clinical characteristics. Patients were monitored in the pediatric cardiac intensive care unit. We analyzed the development of postoperative arrhythmias and the factors associated with them.

Results: In 143 patients, the mean age at the time of surgery was 7.52±6.0 years. There were 83(58.0%) male patients. Tetralogy of Fallot was the most common type of congenital heart disease noted in 57(39.0%) patients. The mean cardiopulmonary bypass time was 83.9±25.5 minutes, while the mean aortic cross-clamp time was 58.1±21.9 minutes. Post-operatively, arrhythmia was observed in 39(27.3%) children. Intra-operative arrhythmias (p<0.001), prolonged cardiopulmonary bypass time (p=0.008), prolonged cross-clamp time (p<0.001), higher inotropic score (p<0.001) and lower post-operative left ventricular ejection fraction (p=0.001) were significantly associated with arrhythmias.

Conclusion: The post-operative arrhythmias among patients undergoing congenital heart surgeries was high. Intra-operative arrhythmias, prolonged cardiopulmonary bypass time, decreased post-operative left ventricular ejection fraction, and high inotropic score were significant risk factors for the development of post-operative arrhythmias.

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