Our Summary

This study looked at whether the time of day a child has heart surgery affects their recovery. It did this by reviewing the medical records of over 23,000 children who had heart surgery between 2014 and 2021. The study compared children who had surgery in the morning (between 8 AM and 11 AM) with those who had surgery in the afternoon (between 2 PM and 5 PM).

The results showed that fewer children died or had a low heart output (when the heart is not pumping enough blood) after afternoon surgery than morning surgery. This was also true for certain groups of children, such as those aged 3 to 18 years old, those weighing between 6.1 and 8.7 kg or more than 13 kg, and those having more complex surgeries (as rated by a scoring system called the STAT category).

The researchers also noticed that the later the surgery started, the lower the risk of these problems. This suggests that scheduling certain types of heart surgery in the afternoon might be a good idea, but more research is needed to confirm this.

FAQs

  1. What was the main focus of the study on pediatric cardiac surgery?
  2. Did the study find any differences in recovery based on the time of day the surgery was performed?
  3. What groups of children did the study find especially benefitted from afternoon surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pediatric cardiac surgery is to ask about scheduling the surgery in the afternoon, as research suggests that this may lead to better outcomes for certain groups of children. However, it is important to discuss this with your child’s healthcare team to determine the best timing for their specific situation.

Suitable For

Pediatric patients who are recommended for pediatric cardiac surgery typically have congenital heart defects, acquired heart diseases, or other cardiac conditions that require surgical intervention. These patients may include infants, children, and adolescents with conditions such as atrial septal defects, ventricular septal defects, tetralogy of Fallot, pulmonary valve stenosis, coarctation of the aorta, and other complex cardiac anomalies. The decision to recommend pediatric cardiac surgery is usually made by a multidisciplinary team of pediatric cardiologists, cardiac surgeons, and other healthcare professionals based on the individual patient’s specific condition and overall health status.

Timeline

Before pediatric cardiac surgery:

  1. Diagnosis of heart condition
  2. Consultation with pediatric cardiologist and cardiac surgeon
  3. Pre-operative tests and evaluations
  4. Discussion of treatment options and surgical plan with parents
  5. Pre-operative preparation and instructions for the child and family

After pediatric cardiac surgery:

  1. Recovery in the intensive care unit (ICU)
  2. Monitoring of vital signs and heart function
  3. Pain management and care of surgical incision
  4. Gradual weaning off of mechanical ventilation
  5. Physical therapy and rehabilitation to regain strength and mobility
  6. Follow-up appointments with the cardiac surgeon and cardiologist
  7. Long-term management of heart condition with medications and lifestyle changes.

What to Ask Your Doctor

  1. How does the time of day impact the outcome of pediatric cardiac surgery?
  2. What are the potential risks and benefits of scheduling surgery in the morning versus the afternoon?
  3. Are there specific factors that make afternoon surgery more beneficial for certain age groups or types of surgeries?
  4. How does the STAT category scoring system play a role in determining the best time for surgery?
  5. Are there any other factors, besides time of day, that can impact the success of pediatric cardiac surgery?
  6. What additional research is needed to further understand the relationship between time of day and surgical outcomes in pediatric cardiac surgery?
  7. How can parents and caregivers best prepare their child for heart surgery, regardless of the time of day it is scheduled?

Reference

Authors: Tong C, Du X, Zhang K, Shan M, Zhang H, Zheng J. Journal: Ann Med. 2024 Dec;56(1):2430764. doi: 10.1080/07853890.2024.2430764. Epub 2024 Nov 22. PMID: 39575562