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- Title
Postoperative Heart Block in Children with Common Forms of Congenital Heart Disease: Results from the KID Database.
- Authors
ANDERSON, JEFFREY B.; CZOSEK, RICHARD J.; KNILANS, TIMOTHY K.; MEGANATHAN, KARTHIKEYAN; HEATON, PAMELA
- Abstract
Postoperative Heart Block in Congenital Heart Disease. Introduction: Cardiac conduction system injury is a cause of postoperative cardiac morbidity following repair of congenital heart disease (CHD). The national occurrence of postoperative complete heart block (CHB) following surgical repair of CHD is unknown. We sought to describe the occurrence of and costs related to postoperative CHB following surgical repair of common forms of CHD using a large national database. Methods and Results: Retrospective, observational analysis performed over a 10-year period (2000-2009) using the Kids' Inpatient Database (KID). Visits for patients ≤24 months of age were identified who underwent surgical repair of ventricular septal defects (VSD), atrioventricular canal defects (AVC), and tetralogy of Fallot (TOF). Patients were identified who were diagnosed with postoperative CHB, further identifying those requiring a new pacemaker placement during the same hospitalization. Costs associated with visits were calculated. There were 16,105 surgical visits: 7,146 VSD, 3,480 AVC, and 5,480 TOF. There was a decrease in postoperative mortality (P = 0.0001) with no significant change in postoperative CHB. Hospital stay and cost were higher with CHB and placement of a permanent pacemaker. Repair of AVC (OR 1.77; [1.32-2.38]) was associated with a higher rate of postoperative CHB. Length of hospital stay and total cost were significantly increased with the development of postoperative CHB and increased further with placement of a permanent pacemaker. Conclusion: There has been little change over time in the frequency of postoperative CHB in patients undergoing repair of VSD, AVC, and TOF. Postoperative CHB results in major added cost to the healthcare system. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1349-1354, December 2012)
- Subjects
OHIO; CARDIAC pacemakers; CHI-squared test; CONFIDENCE intervals; CONGENITAL heart disease; EPIDEMIOLOGY; HEART block; LENGTH of stay in hospitals; HOSPITAL costs; SCIENTIFIC observation; RESEARCH funding; SURGICAL complications; OPERATIVE surgery; LOGISTIC regression analysis; DATA analysis; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; CHILDREN
- Publication
Journal of Cardiovascular Electrophysiology, 2012, Vol 23, Issue 12, p1349
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/j.1540-8167.2012.02385.x