Document Detail


Frequency and indications for tracheostomy and gastrostomy after congenital heart surgery.
MedLine Citation:
PMID:  19011726     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients undergoing congenital heart surgery may occasionally require additional surgical procedures in the form of tracheostomy and gastrostomy. These procedures are often performed in an attempt to diminish hospital morbidity and length of stay. We reviewed the Web-based medical records of all patients undergoing congenital heart surgery at Miami Children's Hospital from February 2002 through August 2007. Patients who were deemed preterm and had undergone closure of a patent ductus arteriosis were eliminated. The records of all other patients were queried for the terms gastrostomy, g-tube, Nissan, fundal plication, tracheostomy, or tracheotomy. Patients' medical records in which these terms appeared in any portion were completely reviewed. There were 1660 congenital heart operations performed in the study period. There were 592 operations performed on patients whose age ranged from 1 month to 1 year and 441 neonatal operations. Mortality was 2%. Median postoperative stay was 8 days (range, 1-191 days), 12 days for neonates (range, 3-142 days), and 19 days for neonates undergoing RACHS-1 category 6 operations (range, 4-142 days). Tracheostomies were performed in four patients (0.2%). Gastrostomies were performed on eight patients (0.4%), representing 0.8% of patients <1 year of age, 1.4% of neonates, and 2.4% of patients undergoing RACHS-1 category 6 operations. The rate of patients undergoing either tracheostomy or gastrostomy after congenital heart surgery at our institution was quite low. Avoidance of either of these two procedures was achieved without increased morbidity or length of stay. The rate at which these procedures need to be performed may reflect the magnitude of the patients' lifetime trauma related to their underlying condition and acute and total surgical experiences.
Authors:
Anthony F Rossi; Steven Fishberger; Robert L Hannan; Jo Ann Nieves; Juan Bolivar; Nancy Dobrolet; Redmond P Burke
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-11-15
Journal Detail:
Title:  Pediatric cardiology     Volume:  30     ISSN:  1432-1971     ISO Abbreviation:  Pediatr Cardiol     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-06     Completed Date:  2009-09-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  225-31     Citation Subset:  IM    
Affiliation:
Congenital Heart Institute, Miami Children's Hospital, Miami, FL 33155, USA. anthony.rossi@mch.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cardiac Surgical Procedures / methods*
Child
Child, Preschool
Florida / epidemiology
Follow-Up Studies
Gastrostomy / utilization*
Heart Defects, Congenital / surgery*
Humans
Infant
Infant, Newborn
Length of Stay / trends
Morbidity
Postoperative Complications / epidemiology,  surgery*
Postoperative Period
Prospective Studies
Tracheostomy / utilization*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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