@Article{CHD.2020.011983,
AUTHOR = {Mingjie Zhang, Wenyi Luo, Liping Wang, Xi Chen, Nan Bao, Zhuoming Xu},
TITLE = {Causes of Death after Congenital Heart Surgery in Children},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {15},
YEAR = {2020},
NUMBER = {5},
PAGES = {377--386},
URL = {http://www.techscience.com/schd/v15n5/40258},
ISSN = {3071-1738},
ABSTRACT = {Background: This retrospective cohort study aimed to explore
the causes of death in children with congenital heart disease (CHD) after cardiac
surgery in one of the biggest cardiac centers for children with CHD in China.
Methods: A total of 26,856 children undergoing cardiac surgery from January
1, 2012 to December 31, 2019 were included. Based on the clinical data, the
causes of death were divided into ten categories and further compared among different periods, types of CHD and surgical procedures. Results: Of all patients,
513 (1.9%) died (median age 162 d, median weight 5.6 kg). The mortality in
2016–2019 was lower than that in 2012–2015 (1.4 ± 0.3% vs. 2.5 ± 0.3%, p =
0.005). A total of 42.5% of children died of heart failure, and 32.9% died of residual anatomic defects. Patients with transposition of the great arteries tended to
die from residual anatomic defects (21.9%), while those with double-outlet right
ventricle (20%) and single ventricle (20%) tended to die from pulmonary hypertension (PH) (p = 0.006). After biventricular repair, children tended to die from
heart failure (90.4%), while after single-ventricle repair, children tended to die
from PH (50%) (p < 0.0001). There is a negative correlation between mortality
and the ECMO implantation rate (r = −0.898, p = 0.002). Conclusions: Heart failure and residual anatomic defects were the main causes of death after cardiac surgery. The cause of death patterns differed among CHD types and surgical
strategies. ECMO may be a life-saving tool when other conventional therapies
do not work.},
DOI = {10.32604/CHD.2020.011983}
}