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Postoperative Heart Block in Children with Common Forms of Congenital Heart Disease: Results from the KID Database
Article first published online: 26 JUN 2012
© 2012 Wiley Periodicals, Inc.
Journal of Cardiovascular Electrophysiology
Volume 23, Issue 12, pages 1349–1354, December 2012
How to Cite
ANDERSON, J. B., CZOSEK, R. J., KNILANS, T. K., MEGANATHAN, K. and HEATON, P. (2012), Postoperative Heart Block in Children with Common Forms of Congenital Heart Disease: Results from the KID Database. Journal of Cardiovascular Electrophysiology, 23: 1349–1354. doi: 10.1111/j.1540-8167.2012.02385.x
- Issue published online: 14 DEC 2012
- Article first published online: 26 JUN 2012
- Manuscript received 13 March 2012; Revised manuscript received 1 May 2012; Accepted for publication 21 May 2012.
- congenital heart disease;
- medical economics;
- postoperative heart block;
- surgical complication
Postoperative Heart Block in Congenital Heart Disease.
Introduction: Cardiac conduction system injury is a cause of postoperative cardiac morbidity following repair of congenital heart disease (CHD). The national occurrence of postoperative complete heart block (CHB) following surgical repair of CHD is unknown. We sought to describe the occurrence of and costs related to postoperative CHB following surgical repair of common forms of CHD using a large national database.
Methods and Results: Retrospective, observational analysis performed over a 10-year period (2000–2009) using the Kids’ Inpatient Database (KID). Visits for patients ≤24 months of age were identified who underwent surgical repair of ventricular septal defects (VSD), atrioventricular canal defects (AVC), and tetralogy of Fallot (TOF). Patients were identified who were diagnosed with postoperative CHB, further identifying those requiring a new pacemaker placement during the same hospitalization. Costs associated with visits were calculated. There were 16,105 surgical visits: 7,146 VSD, 3,480 AVC, and 5,480 TOF. There was a decrease in postoperative mortality (P = 0.0001) with no significant change in postoperative CHB. Hospital stay and cost were higher with CHB and placement of a permanent pacemaker. Repair of AVC (OR 1.77; [1.32–2.38]) was associated with a higher rate of postoperative CHB. Length of hospital stay and total cost were significantly increased with the development of postoperative CHB and increased further with placement of a permanent pacemaker.
Conclusion: There has been little change over time in the frequency of postoperative CHB in patients undergoing repair of VSD, AVC, and TOF. Postoperative CHB results in major added cost to the healthcare system. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1349-1354, December 2012)