Vol. 8, Issue 4, Part A (2024)

Background: Paediatric cardiac surgery is a specialized field addressing congenital and acquired heart diseases in children. Congenital heart disease (CHD), the most common congenital disability, affects approximately 8 per 1,000 live births. Surgical intervention is often necessary, with 25% of infants with CHD requiring surgery in their first year. Advances in surgery, anesthetics, and critical care have improved survival rates, but morbidity remains high in resource-limited settings.

Aim of the study: The present study aims to evaluate the outcomes of paediatric cardiac surgery in a tertiary care hospital.

Methods: This prospective analytical study was conducted at the Department of Obstetrics & Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, over one year. Purposive sampling selected 445 pediatric patients with cardiac issues aged one month to 16 years. Exclusions included neonates and children without parental consent. Informed consent was obtained, and data were kept confidential. Ethical approval was granted. Daily monitoring identified postoperative complications. Data included age, sex, diagnosis, outcomes, and complications. Risk factors for major complications were analyzed using the RACHS-1 category and statistical methods. Results were presented using SPSS software, version 26.

Result: The study involved 445 children with an average age of 49.32 months, nearly evenly split between genders. Notably, 42.02% were undernourished, 20.90% had failed to thrive, and 6.07% had syndromic conditions. The most common cardiac diagnosis was ventricular septal defect (28.99%). Most patients (83.82%) were in the RACHS-1 category two surgical risk. Post-surgery, 78.88% required cardiopulmonary bypass, with a mean ICU stay of 34.91 hours. General complications were prevalent (77.98%), with endocrine issues being most common (80.00%). Major complications included death (14.16%). Predictors of complications included congestive heart failure, cyanotic CHD, long CPB duration, and increased lactate postoperatively.

Conclusion: The study found a 14.16% in-hospital mortality rate for pediatric cardiac surgery. Key predictors of major complications include cyanotic congenital heart disease, prolonged bypass duration, high inotropic support, and elevated lactate levels. High complication rates highlight the need for better surgical techniques and postoperative care.