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Early outcome of children with complex atrial isomerism undergoing uni-ventricular cardiac palliation

Giridhar V Santhanam1, Hani K Najm, Johannes P Duplessis

  • 1Cardiac Science Department, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.

Saudi Medical Journal
|December 7, 2007
PubMed

Insights

Children with atrial isomerism and complex heart defects undergoing uni-ventricular repair had challenging but comparable outcomes to literature. Early results showed significant morbidity but also successful staged surgical palliation.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Cardiac Surgery

Background:

  • Atrial isomerism is a rare condition often associated with complex congenital heart disease (CHD).
  • Management of these complex cardiac defects in children requires specialized surgical approaches, including uni-ventricular repair.

Purpose of the Study:

  • To evaluate the intensive care unit (ICU) course and early outcomes of pediatric patients with atrial isomerism undergoing uni-ventricular heart repair.
  • To assess the challenges and potential risks associated with surgical repair in this patient population.

Main Methods:

  • Retrospective review of pediatric patients with atrial isomerism who underwent uni-ventricular repair between January 2000 and December 2004.
  • Analysis of ICU course, complications, and early surgical outcomes.

Main Results:

  • Ten patients underwent uni-ventricular repair, with an 80% survival rate for the first stage.
  • Complications such as sepsis and prolonged mechanical ventilation occurred in 40% of cases.
  • Over 50% of operated patients experienced prolonged ICU stays (>2 weeks).

Conclusions:

  • Atrial isomerism frequently presents with complex cardiac defects requiring staged surgical repair.
  • Surgical management and peri-operative care for these patients are challenging, carrying risks of morbidity and mortality.
  • Outcomes for children with atrial isomerism undergoing uni-ventricular palliation in this setting were comparable to existing literature.
Abstract

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