All issues > Volume 53(4); 2010

Original Article

Korean J Pediatr. 2010;53(4):532-537. Published online April 15, 2010.

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

Hee Joung HJ Choi¹, Yeo Hyang YH Kim², Joon Yong JY Cho³, Myung Chul MC Hyun², Sang Bum SB Lee², Kyu Tae KT 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

Correspondence Myung Chul MC 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.

Keywords :Cardiac arrhythmia, Open heart surgery, Congenital heart disease, Child