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The Impact of Concomitant Left Ventricular Non-compaction with Congenital Heart Disease on Perioperative Outcomes

Preeti Ramachandran1, Jessica G Woo2, Thomas D Ryan3

  • 1The Heart Institute, Cincinnati Children's Hospital, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA. preeti.ramachandran@cchmc.org.

Pediatric Cardiology
|July 1, 2016
PubMed

Insights

Children with left ventricular non-compaction (LVNC) and congenital heart disease (CHD) face significantly higher risks during surgery. These patients experienced longer hospital stays and more severe complications compared to those with CHD alone.

Area of Science:

  • Cardiology
  • Pediatric Cardiac Surgery
  • Cardiomyopathy Research

Background:

  • Left ventricular non-compaction (LVNC) is a myocardial disorder with prominent trabeculations, often co-occurring with congenital heart disease (CHD).
  • The impact of concomitant LVNC on surgical outcomes in pediatric CHD patients remains understudied.

Purpose of the Study:

  • To evaluate the perioperative outcomes of pediatric patients with LVNC and CHD (LVNC-CHD) undergoing surgery.
  • To compare surgical outcomes between LVNC-CHD patients and a control group of CHD-only patients.

Main Methods:

  • Retrospective review of pediatric patients (0-5 years) diagnosed with LVNC-CHD who underwent surgery.
  • Comparison with a matched control group of pediatric patients (0-5 years) with CHD but without LVNC (CHD-only).
  • Collection and analysis of perioperative data, including length of hospital stay and postoperative complications.

Main Results:

  • LVNC-CHD patients had a significantly longer median hospital stay (12.5 days) compared to CHD-only patients (5 days).
  • A higher rate of severe adverse events (postoperative death, cardiac arrest, ECMO, or transplantation) was observed in LVNC-CHD patients (30%) versus CHD-only patients (1%).
  • LVNC-CHD patients experienced significantly increased perioperative complications compared to CHD-only controls.

Conclusions:

  • Concomitant LVNC in pediatric CHD patients is associated with substantially increased perioperative risks and longer hospitalizations.
  • Pediatric cardiac care teams must recognize the heightened risks in LVNC-CHD patients.
  • Further prospective studies are necessary to fully elucidate the implications of LVNC in pediatric CHD surgery.

Keywords:
Cardiac surgeryCardiomyopathyCongenital heart diseaseLeft ventricular non-compactionLeft ventricular trabeculationsPostoperative outcomes

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