Our Summary

This research paper examined the data on how frequently children with heart conditions need emergency surgery due to complications during heart procedures. The researchers looked specifically at complications involving damage to the heart or blood vessels, and issues with medical devices used in the procedures.

They found that these complications are rare but can have serious consequences. Out of over 25,000 cases studied, damage to the heart or blood vessels occurred in about 0.36% of cases and issues with medical devices happened in about 0.68% of cases.

These complications can lead to the need for emergency heart surgery, the use of a machine (ECMO) to support the heart and lungs, or even death. The study found that emergency surgeries were needed in about 20% of cases with heart or blood vessel damage, and in about 13% of cases with device issues. Deaths occurred in around 10% of cases with heart or blood vessel damage, and in about 2% of cases with device issues.

However, the survival rate after emergency surgery because of these complications was fairly high - 68% for heart or blood vessel damage, and 96% for device issues.

Certain case types, such as procedures involving the pulmonary valve or the wall between the two upper chambers of the heart, had a higher risk of complications. Also, patients who had surgery in the last 30 days or who had emergency cases had a higher chance of complications.

The researchers conclude that while these complications are rare, they are serious and can require immediate surgical intervention. Therefore, it is important to have surgical and ECMO support readily available during these procedures, especially for those cases with a higher risk of complications.

FAQs

  1. What are the common complications during heart procedures in children?
  2. How often do complications from heart procedures in children require emergency surgery?
  3. What is the survival rate after emergency surgery due to complications in heart procedures in children?

Doctor’s Tip

A doctor might advise a patient undergoing cardiac surgery to follow all pre-operative instructions carefully, including fasting before the surgery, taking medications as directed, and avoiding certain foods or drinks. They may also recommend maintaining a healthy lifestyle, including regular exercise and a balanced diet, to improve overall heart health and reduce the risk of complications during and after surgery. Additionally, the doctor may stress the importance of attending all follow-up appointments and contacting them immediately if any concerning symptoms or issues arise post-surgery.

Suitable For

Patients who are typically recommended cardiac surgery include those with congenital heart defects, coronary artery disease, heart valve disease, heart failure, and other heart conditions that cannot be effectively treated with medication or other non-invasive treatments. Additionally, patients who have experienced complications during heart procedures, such as damage to the heart or blood vessels, or issues with medical devices, may also be recommended for cardiac surgery to address these issues and prevent further complications.

Timeline

Before cardiac surgery:

  1. Patient is diagnosed with a heart condition that requires surgical intervention.
  2. Patient undergoes pre-operative testing and evaluation to assess their overall health and determine the best course of treatment.
  3. Patient meets with their surgical team to discuss the procedure, risks, and potential outcomes.
  4. Patient may need to make lifestyle changes or take medication to prepare for surgery.
  5. Day of surgery, patient is admitted to the hospital and prepared for the procedure.

After cardiac surgery:

  1. Patient undergoes the surgical procedure, which may involve repairing damaged heart tissue, replacing heart valves, or bypassing blocked arteries.
  2. Patient is monitored closely in the intensive care unit (ICU) immediately after surgery to ensure they are stable and recovering well.
  3. Patient may need to stay in the hospital for several days or weeks depending on the complexity of the surgery and their individual recovery.
  4. Patient will undergo rehabilitation and physical therapy to regain strength and mobility after surgery.
  5. Patient will have follow-up appointments with their surgical team to monitor their progress and make any necessary adjustments to their treatment plan.
  6. Patient may need to make long-term lifestyle changes, such as diet and exercise, to maintain heart health and prevent future complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cardiac surgery include:

  1. What are the potential risks and complications associated with this surgery?
  2. What is the success rate of this surgery for my specific condition?
  3. What is the recovery process like and how long will it take?
  4. Will I need any follow-up procedures or treatments after the surgery?
  5. What is the experience and success rate of the surgical team performing the procedure?
  6. What are the alternatives to surgery and are they viable options for me?
  7. How long will I need to stay in the hospital after the surgery?
  8. What lifestyle changes will I need to make post-surgery to ensure a successful recovery?
  9. What symptoms should I watch out for that may indicate complications after the surgery?
  10. What support services are available to help me through the recovery process?

Reference

Authors: Holzer R, Batlivala SP, Boe B, Goldstein B, Gudausky T, Hasan B, O’Byrne M, Quinn B, Sathanadam S, Shahanavaz S, Trucco SM, Zampi JD, Bergersen L. Journal: Pediatr Cardiol. 2023 Apr;44(4):795-805. doi: 10.1007/s00246-023-03126-9. Epub 2023 Feb 20. PMID: 36806971