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Arslanoğlu E, Kara KA, Yiğit F, Arkan C, Uslu U, Şavluk ÖF, Yılmaz AA, Tunçer E, Çine N, Ceyran H. Neurological complications after pediatric cardiac surgery. THE CARDIOTHORACIC SURGEON 2021; 29:19. [PMID: 38624732 PMCID: PMC8448664 DOI: 10.1186/s43057-021-00056-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/03/2021] [Indexed: 11/30/2022] Open
Abstract
Background The number of pediatric patients who survive open-heart surgery has increased in recent years and the complications seen in this patient group continue to decrease with each technological advance, including new surgical and neuroprotective techniques and the improvement in surgeons' experience with this patient population. However, neurological complications, which are the most feared and difficult to manage, require long-term follow-up, and increase hospital costs remain a leading cause of mortality and morbidity in this cohort. Results We evaluated the neurological physical examination, cranial computed tomography (CT), and magnetic resonance (MRI) records of 162 pediatric patients with neurological symptoms lasting more than 24 h after undergoing heart surgery in our clinic between June 2012 and May 2020. The patients' ages ranged from 0 to 205 months, with a mean of 60.59 ± 46.44 months.Of the 3849 pediatric cardiac surgery patients we screened, 162 had neurological complications in the early period (the first 10 days after surgery). The incidence was calculated as 4.2%; 69 patients (42.6%) experienced seizures, 17 (10.5%) experienced confusion, 39 (24.1%) had stupor, and 37 (22.8%) had hemiparesis. Of the patients who developed neurological complications, 54 (33.3%) died. Patients with neurological complications were divided into 3 groups: strokes (n = 90), intracranial bleeding (n = 37), and no radiological results (n = 35). Thirty-four patients (37.8%) in the stroke group died, as did 15 (40%) in the bleeding group, and 5 (14.3%) in the no radiological results group. Conclusions Studies on neurological complications after pediatric heart surgery in the literature are currently insufficient. We think that this study will contribute to a more detailed discussion of the issue. Responses to neurological events and treatment in the pediatric group may differ compared to the adult age group. Primary prevention methods should be the main approach in combating neurological complications; their formation mechanisms should be carefully monitored and preventive treatment strategies should be developed.
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Affiliation(s)
- Ergin Arslanoğlu
- Pediatric Cardiovascular Surgery Department, Kartal Kosuyolu High Education and Training Hospital, Cevizli, 2, Denizer Caddesi, Cevizli Kavşağı, 34865 Kartal, Istanbul, Turkey
| | - Kenan Abdurrahman Kara
- Pediatric Cardiovascular Surgery Department, Kartal Kosuyolu High Education and Training Hospital, Cevizli, 2, Denizer Caddesi, Cevizli Kavşağı, 34865 Kartal, Istanbul, Turkey
| | - Fatih Yiğit
- Pediatric Cardiovascular Surgery Department, Kartal Kosuyolu High Education and Training Hospital, Cevizli, 2, Denizer Caddesi, Cevizli Kavşağı, 34865 Kartal, Istanbul, Turkey
| | - Cüneyt Arkan
- Pediatric Cardiovascular Surgery Department, Kartal Kosuyolu High Education and Training Hospital, Cevizli, 2, Denizer Caddesi, Cevizli Kavşağı, 34865 Kartal, Istanbul, Turkey
| | - Ufuk Uslu
- Anesthesia and Reanimation Department, Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
| | - Ömer Faruk Şavluk
- Anesthesia and Reanimation Department, Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
| | - Abdullah Arif Yılmaz
- Pediatric Cardiovascular Surgery Department, Kartal Kosuyolu High Education and Training Hospital, Cevizli, 2, Denizer Caddesi, Cevizli Kavşağı, 34865 Kartal, Istanbul, Turkey
| | - Eylem Tunçer
- Pediatric Cardiovascular Surgery Department, Kartal Kosuyolu High Education and Training Hospital, Cevizli, 2, Denizer Caddesi, Cevizli Kavşağı, 34865 Kartal, Istanbul, Turkey
| | - Nihat Çine
- Pediatric Cardiovascular Surgery Department, Kartal Kosuyolu High Education and Training Hospital, Cevizli, 2, Denizer Caddesi, Cevizli Kavşağı, 34865 Kartal, Istanbul, Turkey
| | - Hakan Ceyran
- Pediatric Cardiovascular Surgery Department, Kartal Kosuyolu High Education and Training Hospital, Cevizli, 2, Denizer Caddesi, Cevizli Kavşağı, 34865 Kartal, Istanbul, Turkey
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