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Tracheostomy After Operations for Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.

Publication ,  Journal Article
Mastropietro, CW; Benneyworth, BD; Turrentine, M; Wallace, AS; Hornik, CP; Jacobs, JP; Jacobs, ML
Published in: Ann Thorac Surg
June 2016

BACKGROUND: Information concerning tracheostomy after operations for congenital heart disease has come primarily from single-center reports. We aimed to describe the epidemiology and outcomes associated with postoperative tracheostomy in a multi-institutional registry. METHODS: The Society of Thoracic Surgeons Congenital Heart Database (2000 to 2014) was queried for all index operations with the adverse event "postoperative tracheostomy" or "respiratory failure, requiring tracheostomy." Patients with preoperative tracheostomy or weighing less than 2.5 kg undergoing isolated closure of patent ductus arteriosus were excluded. Trends in tracheostomy incidence over time from January 2000 to June 2014 were analyzed with a Cochran-Armitage test. The patient characteristics associated with operative mortality were analyzed for January 2010 to June 2014, including deaths occurring up to 6 months after transfer of patients to long-term care facilities. RESULTS: From 2000 to 2014, the incidence of tracheostomy after operations for congenital heart disease increased from 0.11% in 2000 to a high of 0.76% in 2012 (p < 0.0001). From 2010 to 2014, 648 patients underwent tracheostomy. The median age at operation was 2.5 months (25th, 75th percentile: 0.4, 7). Prematurity (n = 165, 26%), genetic abnormalities (n = 298, 46%), and preoperative mechanical ventilation (n = 275, 43%) were common. Postoperative adverse events were also common, including cardiac arrest (n = 131, 20%), extracorporeal support (n = 87, 13%), phrenic or laryngeal nerve injury (n = 114, 18%), and neurologic deficit (n = 51, 8%). The operative mortality was 25% (n = 153). CONCLUSIONS: Tracheostomy as an adverse event of operations for congenital heart disease remains rare but has been increasingly used over the past 15 years. This trend and the considerable mortality risk among patients requiring postoperative tracheostomy support the need for further research in this complex population.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

June 2016

Volume

101

Issue

6

Start / End Page

2285 / 2292

Location

Netherlands

Related Subject Headings

  • Tracheostomy
  • Sepsis
  • Respiratory System
  • Respiratory Insufficiency
  • Respiration, Artificial
  • Prognosis
  • Postoperative Complications
  • Male
  • Infant, Premature, Diseases
  • Infant, Premature
 

Citation

APA
Chicago
ICMJE
MLA
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Mastropietro, C. W., Benneyworth, B. D., Turrentine, M., Wallace, A. S., Hornik, C. P., Jacobs, J. P., & Jacobs, M. L. (2016). Tracheostomy After Operations for Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg, 101(6), 2285–2292. https://doi.org/10.1016/j.athoracsur.2016.01.046
Mastropietro, Christopher W., Brian D. Benneyworth, Mark Turrentine, Amelia S. Wallace, Christoph P. Hornik, Jeffrey P. Jacobs, and Marshall L. Jacobs. “Tracheostomy After Operations for Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.Ann Thorac Surg 101, no. 6 (June 2016): 2285–92. https://doi.org/10.1016/j.athoracsur.2016.01.046.
Mastropietro CW, Benneyworth BD, Turrentine M, Wallace AS, Hornik CP, Jacobs JP, et al. Tracheostomy After Operations for Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg. 2016 Jun;101(6):2285–92.
Mastropietro, Christopher W., et al. “Tracheostomy After Operations for Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.Ann Thorac Surg, vol. 101, no. 6, June 2016, pp. 2285–92. Pubmed, doi:10.1016/j.athoracsur.2016.01.046.
Mastropietro CW, Benneyworth BD, Turrentine M, Wallace AS, Hornik CP, Jacobs JP, Jacobs ML. Tracheostomy After Operations for Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg. 2016 Jun;101(6):2285–2292.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

June 2016

Volume

101

Issue

6

Start / End Page

2285 / 2292

Location

Netherlands

Related Subject Headings

  • Tracheostomy
  • Sepsis
  • Respiratory System
  • Respiratory Insufficiency
  • Respiration, Artificial
  • Prognosis
  • Postoperative Complications
  • Male
  • Infant, Premature, Diseases
  • Infant, Premature