Pericardial Effusions After the Arterial Switch Operation: A PHIS Database Review

Area of Science:

• Pediatric Cardiac Surgery
• Cardiovascular Surgery
• Surgical Complications

Background:

• Pericardial effusion (PCE) is a known complication following pediatric cardiac surgery.
• The arterial switch operation (ASO) is a common procedure for dextro-transposition of the great arteries.
• Understanding PCE development and impact after ASO is crucial for patient outcomes.

Purpose of the Study:

• To investigate the incidence of pericardial effusion (PCE) after arterial switch operation (ASO).
• To identify risk factors associated with PCE development post-ASO.
• To evaluate the short-term and longitudinal impacts of PCE on pediatric patients undergoing ASO.

Main Methods:

• Retrospective review of the Pediatric Health Information System database.
• Inclusion of patients with dextro-transposition of the great arteries who underwent ASO between January 1, 2004, and March 31, 2022.
• Analysis using descriptive, univariate, and multivariable regression statistics to compare patients with and without PCE.

Main Results:

• Pericardial effusion (PCE) was diagnosed in 6.1% (300/4896) of patients post-ASO.
• PCE was significantly associated with acute renal failure, pleural effusions, and mechanical circulatory support.
• Patients with PCE experienced a longer postoperative length of stay but showed no difference in readmission rates or in-hospital mortality.

Conclusions:

• Pericardial effusion (PCE) is a notable complication after ASO, occurring in 6.1% of cases.
• Pleural effusions and mechanical circulatory support are identified as risk factors for PCE post-ASO.
• While PCE is linked to increased morbidity and prolonged hospitalization, it does not appear to affect in-hospital mortality or readmission rates.