Related Experiment Video
Updated: Apr 14, 2026
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Emergency department use after stage II palliation for children with single ventricle lesions
Elizabeth Prentice1, Noelle Morey, Kristen Richards
1From the *Division of Pediatric Critical Care, Helen DeVos Children's Hospital, Grand Rapids, MI; †Department of Pediatrics, The Grand Rapids Medical Education Partners/Michigan State University Pediatric Residency Program, Helen Devos Children's Hospital, Grand Rapids; ‡Department of Cardiovascular Surgery, Children's Hospital of Michigan, Wayne State University, Detroit, MI; and §Department of Pediatrics, Division of Critical Care Medicine, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN.
Insights
Emergency department visits are common for infants with single ventricle heart defects after their second surgery. Longer hospital stays post-surgery increase the likelihood of these visits, highlighting the ED
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Surgical Palliation
Background:
- Infants with single ventricle physiology require multi-stage surgical palliation.
- Long-term survival depends on successful completion of these surgical stages.
- Understanding healthcare utilization between stages is crucial for patient management.
Purpose of the Study:
- To investigate the frequency and reasons for emergency department (ED) visits in single ventricle patients.
- To identify factors associated with ED utilization between the second and third surgical palliation stages.
Main Methods:
- Retrospective chart review of patients undergoing stage II palliation (2006-2011).
- Analysis of patient demographics, chief complaints, and postoperative outcomes.
- Statistical comparison using Mann-Whitney U and chi-squared tests.
Main Results:
- 66% of patients (31/47 survivors) had 95 ED visits before stage III.
- Respiratory and gastrointestinal issues were the most frequent chief complaints.
- Longer postoperative length of stay after stage II (≥10 days) significantly increased ED visit likelihood (OR 6.0).
Conclusions:
- Emergency department utilization is frequent in single ventricle patients post-stage II palliation.
- Complicated postoperative courses, indicated by prolonged hospital stays, are associated with increased ED visits.
- The emergency department plays a vital role in managing these complex pediatric cardiac patients.
Background:
Infants born with a single cardiac ventricle require a 3-stage surgical palliation performed during the first few years of life for long-term survival. We aimed to determine the extent to which the emergency department services were used between the second and third surgical stages.
Methods:
A retrospective chart review was performed on patients who underwent stage II palliation at our institution between 2006 and 2011. Data analyses were performed using Mann-Whitney U tests or χ tests as appropriate.
Results:
Fifty patients underwent stage II palliation during the study period, 47 of which survived to hospital discharge. Thirty-one (66%) patients required 95 emergency department visits before stage III. The most common chief complaints were respiratory (n = 39) and gastrointestinal (n = 18 visits) in nature. Age and weight at time of stage II surgery, dominant ventricle, and data from discharge echocardiograms were not significantly different between patients who did and did not require emergency department visits. Median postoperative length of stay after stage II palliation was longer in patients using the emergency department, 11 (interquartile range, 6-17) versus 7 (interquartile range, 5-8) days, P = 0.015. Moreover, patients with lengths of stay greater than 10 days were 6 times more likely to require emergency department services (odds ratio, 6.0; 95% confidence intervals, 1.4-25.4).
Conclusions:
Emergency department use by patients with a single cardiac ventricle is common after their second surgical stage, especially in patients with more complicated postoperative courses. This study emphasizes the important role of the emergency department in the care of these challenging patients.
More Related Videos
07:41Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
Published on: July 20, 2022
05:18Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure
Published on: January 16, 2026
Related Concept Videos
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:29Cardiomyopathy V: Interprofessional Care
01:23Cardiopulmonary Resuscitation III: AED Use
01:26Mitral Stenosis III: Medical Management
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:22Heart Failure VI: Adjunct Therapies