Our Experience in Anesthesia Management in Operations for Congenital Pediatric Cardiac Diseases

Özet

Objectives: Surgical treatment of congenital heart diseases (CHDs) is performed in many centers today. We aimed to review the pediatric cardiac surgery cases performed in our center and contribute to the literature with our data. Materials and Methods: In this study, 92 patients who underwent palliative and complete correction for CHDs between March 2016 and March 2019 were evaluated retrospectively. Results: A total of 92 patients, 37 (40.2%) females and 55 (59.8%) males, were retrospectively examined for this study. The number of patients under and over 1 year of age were 74 (80.44%) and 18 (19.56%), respectively. The most common congenital cardiac anomaly was ventricular septal defect (28.26%). All surgical procedures were classified according to complexity based on the Aristotle Basic Scoring system to find that 45 patients underwent Level 2, 23 patients underwent Level 4, 13 patients underwent Level 1 and 11 patients underwent Level 3 surgeries. Among our patients, 78.2% and 21.8% were operated with and without cardiopulmonary bypass (CPB), respectively. There were no significant differences between patient age groups in terms of operation time, CPB time and cross-clamp time, but the difference between the same parameters according to complexity level was statistically significant (p<0.05). As the complexity level increased, the durations were prolonged. Postoperative complications were found to be increased under 1 year of age and at high complexity levels (Levels 3 and 4). Similarly, it was found that mortality significantly increased under 1 year of age and with high complexity levels (p<0.05). Conclusion: In surgical procedures for CHDs, complexity levels according to Aristotle Basic Scoring System and the patient’s age are effective factors on outcome. We believe that it is necessary to share the experiences of the centers working in this field and to conduct randomized studies with larger sample sizes.