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Early postoperative arrhythmias after open heart surgery of pediatric congenital heart diseas

Korean Journal of Pediatrics 2010;53(4):532-537.
Published online April 15, 2010.
Early postoperative arrhythmias after open heart surgery of pediatric congenital heart diseas
Hee Joung Choi1, Yeo Hyang Kim2, Joon Yong Cho3, Myung Chul Hyun2, Sang Bum Lee2, Kyu Tae Kim3
1Department of Pediatrics, Kumi-Cha hospital, CHA University School of Medicine, Daegu, Korea
2Department of Pediatrics, College of Medicine, Keimyung University, Daegu, Korea
3Department of Thoracic and Cardiovascular Surgery, College of Medicine, Kyungpook National University, Daegu, Korea
소아 선천성 심장병 개심술 후 발생한 조기 부정맥
최희정1, 김여향2, 조준용3, 현명철2, 이상범2, 김규태3
1차의과학대학교 부속 구미차병원 소아청소년과
2계명대학교 의과대학 소아과학교실
3경북대학교 의과대학 흉부외과학교실
Correspondence: 
Myung Chul Hyun, Email: mchyun@knu.ac.kr
Abstract
Purpose
: Early postoperative arrhythmias are a major cause of mortality and morbidity after open heart surgery in the pediatric population. We evaluated the incidence and risk factors of early postoperative arrhythmias after surgery of congenital heart disease.
Methods
: From January 2002 to December 2008, we retrospectively reviewed the medical records of the 561 patients who underwent cardiac surgery in Kyungpook National University Hospital. We analyzed patients' age and weight, occurrence and type of arrhythmia, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time, and postoperative electrolyte levels.
Results
: Arrhythmias occurred in 42 of 578 (7.3%) cases of the pediatric cardiac surgery. The most common types of arrhythmia were junctional ectopic tachycardia (JET) and accelerated idioventricular rhythm (AIVR), which occurred in 17 and 13 cases, respectively. The arterial switch operation (ASO) of transposition of the great arteries (TGA) had the highest incidence of arrhythmia (36.4%). Most cases of cardiac arrhythmia showed good response to management. Patients with early postoperative arrhythmias had significantly lower body weight, younger age, and prolonged CPB and ACC times (P <0.05) than patients without arrhythmia. Although the mean duration of ventilator care and intensive care unit stay were significantly longer (P <0.05), the mortality rate was not significantly different among the 2 groups.
Conclusion
: Early postoperative arrhythmias are a major complication after pediatric cardiac surgery; however, aggressive and immediate management can reduce mortality and morbidity.
Key Words: Cardiac arrhythmia, Open heart surgery, Congenital heart disease, Child


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