Cardiopulmonary bypass complications and their predictors in open-heart surgery at a tertiary cardiac care facility in Tanzania.

Abstract

Background: Cardiopulmonary bypass (CPB) is integral to open-heart surgery but carries significant risks of systemic inflammatory response and organ-specific complications. In low-resource settings, limited local data can impede targeted prevention. This study assessed the frequency and predictors of CPB-related complications at the Jakaya Kikwete Cardiac Institute, Tanzania. Methods: A retrospective review examined 195 pediatric and adult patients who underwent open-heart surgery in 2020. Data from perfusion records and ICU charts were analyzed using descriptive statistics and univariate logistic regression. Results: Of the cohort, 55.4% were male and 52.3% were under 16 years. Valvular heart disease was the most common diagnosis (42.1%). At least one major complication occurred in 31.3% of patients, with cardiovascular (10.8%) and bleeding (9.2%) events predominating. Prolonged ICU stay affected 52.8% of cases and in-hospital mortality was 4.1%. Key predictors of complications included younger age, diagnosis type, procedure type, CPB duration, and cross-clamp time. CPB time exceeding 120 min significantly increased the likelihood of prolonged ICU stay. Conclusions: CPB-related complications represent a substantial burden in this setting. Minimising CPB and cross-clamp durations may improve outcomes. Prospective locally driven research is needed to refine management strategies.