Our Summary

This research investigates the connection between the lowest body temperature during surgery (nadir intraoperative temperature or NIT) and early brain-related complications in newborns undergoing heart surgery due to congenital heart disease. The study analyzed data from over 24,000 newborn heart surgeries that took place from 2010 to 2019.

The results showed that surgeons are leaning towards keeping body temperatures higher during these procedures. They also found that lower body temperatures during surgery did not significantly increase the overall risk of brain-related complications. However, for one particular type of surgery, the Norwood procedure, lower body temperatures appeared to be beneficial.

Other factors that increased the risk of these complications included being younger at the time of surgery, longer bypass times, being born prematurely, having non-heart related abnormalities, and chromosomal anomalies.

In summary, while brain-related complications are common after newborn heart surgery, current surgical practices of maintaining relatively higher body temperatures seem to be supported by these findings. However, reducing temperatures might be beneficial in specific cases or procedures.

FAQs

  1. What is the connection between the body temperature during surgery and early brain-related complications in newborns undergoing heart surgery?
  2. How does the body temperature during surgery impact the risk of brain-related complications after the Norwood procedure?
  3. What are some other factors that increased the risk of early brain-related complications in newborns undergoing heart surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cardiac surgery is to discuss the potential risks and benefits of maintaining body temperature during the procedure. It’s important for patients to understand that lower body temperatures may be beneficial in certain situations, but overall, current practices aim to keep body temperatures higher to reduce the risk of brain-related complications. Patients should feel comfortable asking their healthcare team any questions or concerns they may have about the surgical process.

Suitable For

Patients who are typically recommended for cardiac surgery include those with congenital heart disease, coronary artery disease, heart valve disease, arrhythmias, and other heart conditions that cannot be managed effectively with medication or other treatments. Patients may also be recommended for cardiac surgery if they are at high risk for heart attack, stroke, or other serious complications. Additionally, patients who have already undergone previous heart procedures or surgeries that have not been successful may also be candidates for cardiac surgery.

Timeline

Before cardiac surgery:

  1. Patient is diagnosed with a heart condition that requires surgical intervention.
  2. Patient undergoes pre-operative testing and evaluations to assess their overall health and readiness for surgery.
  3. Patient meets with their surgical team to discuss the procedure, risks, and recovery process.
  4. Patient undergoes anesthesia and is prepared for surgery.

During cardiac surgery:

  1. Surgeons perform the necessary procedures to repair or replace damaged heart tissue.
  2. Patient’s body temperature is closely monitored throughout the surgery.
  3. Patient is placed on a heart-lung machine to maintain circulation and oxygenation of the blood.
  4. Surgery typically lasts several hours, depending on the complexity of the procedure.

After cardiac surgery:

  1. Patient is transferred to the intensive care unit (ICU) for monitoring and recovery.
  2. Patient may experience pain, discomfort, and fatigue in the immediate post-operative period.
  3. Patient begins physical therapy and rehabilitation to regain strength and mobility.
  4. Patient is discharged from the hospital and continues with follow-up appointments and cardiac rehabilitation.
  5. Patient may require ongoing medication and lifestyle modifications to manage their heart condition and prevent future complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cardiac surgery based on this research include:

  1. What is the typical range of body temperatures maintained during cardiac surgery for newborns with congenital heart disease?
  2. Are there any specific factors that would make it beneficial to have a lower body temperature during surgery, such as the Norwood procedure?
  3. How do factors like age at surgery, bypass times, prematurity, and other abnormalities affect the risk of brain-related complications?
  4. What steps are taken to minimize the risk of brain-related complications during and after cardiac surgery?
  5. How often do brain-related complications occur in newborns undergoing heart surgery, and what are the potential long-term effects?
  6. Are there any additional precautions or interventions that can be taken to further reduce the risk of brain-related complications in newborns undergoing heart surgery?
  7. What is the follow-up care and monitoring recommended for newborns who have undergone heart surgery to assess any potential brain-related complications?

Reference

Authors: Starr JP, Karamlou T, Steele A, Artis AS, Rajeswaran J, Salim Hammoud M, Gates RN. Journal: J Am Coll Cardiol. 2024 Jul 30;84(5):450-463. doi: 10.1016/j.jacc.2024.04.059. PMID: 39048277