Our Summary

The research was conducted in Jordan, where doctors analyzed the outcomes of cardiac arrests in both adults and children who had undergone heart surgery. They found that cardiac arrests are more common after heart surgery because the heart can be temporarily weaker and more prone to abnormal rhythms. However, they also found that most cardiac arrests in this context can be reversed.

The study involved 1,635 patients (886 adults and 749 children) who had heart surgery over a year and a half period. Out of these, about 7% (114 patients) had a cardiac arrest. They found that cardiac arrests in children often presented differently than in adults - children were more likely to have ’non-shockable’ rhythms, while adults were more likely to have ‘shockable’ rhythms.

The majority of cardiac arrests occurred in the intensive care unit and most of the patients were on a ventilator at the time. The average time for cardiopulmonary resuscitation (CPR) was just over half an hour.

Interestingly, the survival rate was 20% higher in children, with just over half fully recovering, compared to adults. There was also a slightly lower rate of brain injury in children who survived a cardiac arrest compared to adults.

The study concluded that several factors can increase the chances of survival after a cardiac arrest following heart surgery. These include constant monitoring of heart function, prompt recognition and treatment of a severe condition called cardiac tamponade, not interrupting chest compressions during CPR, and if the cardiac arrest is witnessed (meaning medical help can be given immediately).

FAQs

  1. What were the key findings of this study on cardiac arrests in heart surgery patients?
  2. How does the presentation of cardiac arrests differ between adults and children according to the research?
  3. What factors were identified by the study that can increase the chances of survival after a cardiac arrest following heart surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric cardiac surgery is to ensure that their child receives regular follow-up appointments with their cardiologist to monitor their heart health and address any potential issues that may arise. It is important to stay vigilant and proactive in managing their child’s heart condition to prevent complications and ensure the best possible outcomes.

Suitable For

Pediatric patients who are typically recommended for pediatric cardiac surgery include those with congenital heart defects, acquired heart diseases, heart rhythm abnormalities, and other complex cardiac conditions that cannot be managed effectively with medication or less invasive procedures. These patients may range in age from newborns to young adults.

Some specific conditions that may require pediatric cardiac surgery include:

  1. Tetralogy of Fallot
  2. Transposition of the great arteries
  3. Hypoplastic left heart syndrome
  4. Atrial septal defects
  5. Ventricular septal defects
  6. Coarctation of the aorta
  7. Pulmonary valve stenosis
  8. Aortic valve stenosis
  9. Ebstein’s anomaly
  10. Cardiomyopathy

It is important for these patients to be evaluated by a pediatric cardiologist and a pediatric cardiac surgeon to determine if surgery is necessary and if so, what type of surgery would be most appropriate for their specific condition. The goal of pediatric cardiac surgery is to improve the overall function of the heart, alleviate symptoms, and improve the quality of life for the patient.

Timeline

Overall, the timeline for a patient before and after pediatric cardiac surgery includes consultation with a cardiac surgeon, pre-operative tests and evaluations, the surgery itself, recovery in the intensive care unit, and post-operative care. In the case of a cardiac arrest following surgery, the patient may require immediate CPR, defibrillation, and other life-saving measures. After surviving a cardiac arrest, the patient will continue to receive intensive care and monitoring to ensure a full recovery. Long-term follow-up care and rehabilitation may also be needed to address any potential complications or lingering effects of the cardiac arrest.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pediatric cardiac surgery?
  2. What is the success rate of pediatric cardiac surgery in general, and specifically for the type of procedure my child will be undergoing?
  3. What is the expected recovery time for my child after the surgery?
  4. What are the signs and symptoms of a cardiac arrest that I should be aware of?
  5. How will my child be monitored after the surgery to prevent and quickly address any potential complications, such as a cardiac arrest?
  6. What measures are in place in case of a cardiac arrest during or after the surgery?
  7. What steps can be taken to prevent a cardiac arrest from occurring in the first place?
  8. What is the protocol for CPR in the event of a cardiac arrest, and what is the success rate of CPR in this context?
  9. What support services are available for both my child and our family during the surgical process and recovery period?
  10. Are there any long-term effects or considerations to keep in mind after pediatric cardiac surgery?

Reference

Authors: Moh’d AF, Khasawneh MA, Al-Odwan HT, Alghoul YA, Makahleh ZM, Altarabsheh SE. Journal: Med Arch. 2021 Apr;75(2):149-153. doi: 10.5455/medarh.2021.75.149-153. PMID: 34219876