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Pneumonia, wheezing and asthma were more common in children after thymectomy due to open-heart surgery

Rea Rantanen1,2, Minna Honkila1,2, Hanna-Riikka Kämä2

  • 1Department of Paediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland.

Acta Paediatrica (Oslo, Norway : 1992)
|March 19, 2024
PubMed

Insights

Children undergoing early thymectomy for congenital heart defects experienced more infections and respiratory issues like asthma and pneumonia. This highlights the need for careful immunological follow-ups after such procedures.

Area of Science:

  • Pediatric Cardiology
  • Immunology
  • Thoracic Surgery

Background:

  • Congenital heart defects (CHD) are common birth abnormalities.
  • Thymectomy, removal of the thymus gland, is sometimes performed during CHD surgery.
  • The long-term health implications of early thymectomy in children with CHD are not fully understood.

Purpose of the Study:

  • To evaluate the clinical impact of early thymectomy during CHD surgery on children's health.
  • To assess the incidence of infections, respiratory conditions, and hospitalizations in these children compared to controls.

Main Methods:

  • Nationwide study of patients aged 1-15 years who underwent CHD surgery in Finland (2006-2018).
  • Electronic questionnaires completed by parents of cases and matched population-based controls.
  • Exclusion of patients with low birth weight or known immunodeficiency; adjusted odds ratios calculated.

Main Results:

  • Children with CHD who had thymectomy reported significantly more hospitalizations due to infections (aOR 6.3).
  • Increased incidence of pneumonia (aOR 3.5), asthma (aOR 2.5), and wheezing (aOR 2.1) was observed in the CHD group.
  • Response rates were 58% for cases and 31% for controls.

Conclusions:

  • Early thymectomy during open-heart surgery for CHD is associated with increased hospitalizations for infections and respiratory conditions.
  • These findings underscore the critical need for vigilant immunological monitoring in children post-thymectomy.
  • Further research into long-term outcomes is warranted.
Abstract

Keywords:
congenital heart defectheart surgeryimmune systemrespiratory conditionsthymus

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