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. 2024 Sep 23:22:427-437.
doi: 10.1016/j.xjon.2024.09.015. eCollection 2024 Dec.

Intraoperative cardiac arrest in patients undergoing congenital cardiac surgery

Morgan L Brown  1 , Steven J Staffa  1 , Phillip S Adams  2 , Lisa A Caplan  3 , Stephen J Gleich  4 , Jennifer L Hernandez  5 , Martina Richtsfeld  6 , Lori Q Riegger  7 , David F Vener  3
Affiliations

Intraoperative cardiac arrest in patients undergoing congenital cardiac surgery

Morgan L Brown et al. JTCVS Open. .

Abstract

Objective: To describe intraoperative cardiac arrest in patients undergoing congenital heart surgery.

Methods: The Society of Thoracic Surgeons Congenital Heart Surgery Database was queried. Predictors of intraoperative cardiac arrest were assessed using univariate and multivariable analyses. The univariate relationship between intraoperative cardiac arrest was also compared with available outcomes in the database.

Results: A total of 92,764 cases had anesthesia adverse event data, and 357 patients (0.38%) had an intraoperative cardiac arrest. Multivariable predictors of an intraoperative cardiac arrest included age (odds ratio [OR], 0.98 per year; 95% confidence interval [CI], 0.97-0.99; P = .036), preoperative cardiac arrest (<48 hours) (OR, 9.6; 95% CI 6.3-14.6, P < .001), preoperative neurologic deficit (OR, 2.0; 95% CI, 1.3-3.1, P = .002), noninsulin-dependent diabetes mellitus (OR, 6.4; 95% CI, 1.9-21.9, P = .003), increasing Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) category (OR, 2.3 for STAT 5 vs STAT 1; 95% CI, 1.3-3.9, P = .003), urgent (OR, 2.0; 95% CI, 1.6-2.6, P < .001) or emergent surgery (OR, 3.1; 95% CI, 1.9-5.0, P < .001), and increasing length of total operating room time (OR, 1.2 per hour; 95% CI, 1.2-1.3, P < .001). Intraoperative cardiac arrest was associated with a greater 30-day mortality (14.6% vs 1.8%, P < .001). There were more morbidities in the intraoperative cardiac arrest group including postoperative neurologic deficits (12% vs 1.0%, P < .001), multisystem organ failure (5.9% vs 0.7%, P < .001), and greater rates of unplanned reoperation (19.3% vs 5.0%, P < .001) or interventional cardiac catheterization (7% vs 3.2%, P < .001).

Conclusions: The incidence of intraoperative cardiac arrest is low; however, it is an important indicator of significant patient perioperative morbidity and mortality.

Keywords: cardiac anesthesia; cardiac arrest; congenital cardiac surgery.

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Conflict of interest statement

The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest.

Figures

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Intraoperative cardiac arrest in patients undergoing congenital cardiac surgery.
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References

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