Etiologies, Clinical Courses and Outcomes of Pediatric Cardiothoracic Surgery: A Retrospective Analysis of Postsurgery Presentations at the PED.

Abstract

Congenital heart defects, the most common of all birth defects, often necessitate complex postoperative care due to the risk of severe complications. This retrospective cohort study evaluated the clinical presentations, outcomes, and complications in the records of 730 children who underwent 877 cardiothoracic surgeries at Hadassah Medical Center, Jerusalem, from 2011 to 2018. During the first postoperative year, 295 of these patients (40.4%) presented to the Pediatric Emergency Department. Single ventricle defects were associated with higher presentation rates than biventricular repairs (69.3% vs 53.7%, P < .001). Serious bacterial infections were found in 5% of the cases. The overall admission rate was 34%, with a Pediatric Intensive Care Unit admission rate of 1.45%. Complications such as chylothorax and pleural effusion were primarily found in Glenn and Fontan procedures, respectively. The study underscores the complex needs and major health care challenges faced by postsurgical pediatric patients, and emphasizes the importance of informed and prompt management.