Reoperations in congenital heart surgery: causes, surgical techniques, and results in 108 patients [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2006; 34(1): 1-9

Reoperations in congenital heart surgery: causes, surgical techniques, and results in 108 patients

Ersin Erek, Yusuf Kenan Yalçınbaş, Ece Salihoğlu, Tamer Turan, Yasemin Mamur, Ayşe Çolakoğlu, Ayşe Sarıoğlu, Tayyar Sarıoğlu
Acıbadem Bakırköy Hastanesi. Acıbadem Kalp Merkezi, istanbul


OBJECTIVES
We evaluated the causes of reoperations, surgical techniques, and results of patients who had undergone a previous repair by sternotomy for congenital heart defects.

STUDY DESIGN
The study included 108 patients (59 males, 49 females; mean age 10.2±9.7 years; range 9 days to 58 years) who required a reoperation following a repair by sternotomy. A right thoracotomy was performed in three patients, Clamshell incision in three patients, and resternotomy in 102 patients. Thirty-three patients under-went total repair follovving a palliative procedure, while six patients underwent a subsequent palliative procedure. Other reoperations were performed for the follovving: right ventricle outflow tract (n=21), atrioventricular valve (n=16), left ventricle outflovv tract (n=13), Fontan revisions (n=7), arterial switch/double svvitch reoperations (n=7), pulmonary venous retum restenosis (n=2), residual/recurrent atrial/ventricular septal defect (n=2), tricuspid regurgitation and arrhythmia after the Senning operation (n=1).

RESULTS
Hospital mortality occurred in nine patients (8.3%). Thirteen patients (13.1%) experienced a prolonged intensive care unit stay (>1 week). During sternal reentry major hemorrhage occurred in two patients, one of whom died. Postoperative complications included re-exploration for bleeding (n=2), permanent pacemaker implantation (n=2), tracheostomy (n=6), pleural effusion (n=7), pneu-mothorax (n=1), chylothorax (n=1), right diaphragmatic paralysis (n=3), and transient cerebrovascular event (n=1).

CONCLUSION
The majority of reoperations after repair of congenital heart defects are due to staged repairs or to inevitably ensuing problems. Proper indications and tim-ing are essential dependi

Keywords: Cardiac surgical procedures, child; heart defects, congenital/surgery; recurrence; reoperation

How to cite this article
Ersin Erek, Yusuf Kenan Yalçınbaş, Ece Salihoğlu, Tamer Turan, Yasemin Mamur, Ayşe Çolakoğlu, Ayşe Sarıoğlu, Tayyar Sarıoğlu. Reoperations in congenital heart surgery: causes, surgical techniques, and results in 108 patients. Turk Kardiyol Dern Ars. 2006; 34(1): 1-9

Corresponding Author: Tayyar Sarıoğlu
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