Current incidence of acute neurologic complications after open-heart operations in children.

Abstract

BACKGROUND:

Previously, neurologic dysfunction was estimated to complicate 25% or less of pediatric open-heart operations. We sought to determine the current incidence and spectrum of early postoperative neurologic complications.

METHODS:

We undertook a retrospective review of all patients undergoing open heart operations in 1 year at our institution with the goal to identify all neurologic complications occurring in the early postoperative period.

RESULTS:

Open-heart operations were performed in 706 children. Sixteen children (2.3%) had neurologic complications develop, including 9 (1.3%) with definite clinical seizures, 1 with suspected seizures and bilateral subdural hemorrhage, 2 with coma after cardiac arrest, 2 with transient mild choreoathetosis, 1 with facial palsy, and 1 with persistent irritability. Causes of seizure were cyclosporin A toxicity posttransplant (4), cerebral ischemia post cardiac arrest (3), and unknown (2). In infants less than 1 year of age, the incidence of seizures was 1.2%.

CONCLUSIONS:

This review suggests a decrease in acute neurologic morbidity after pediatric open heart operation. Clinical seizures remain the most common complication. Posttransplant, cyclosporin-associated seizures have emerged as an important etiologic category, coincident with an increase in cardiac transplantation in children.

• Authors: Caroline C Menache, Adré J du Plessis, David L Wessel, Richard A Jonas, Jane W Newburger
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 73 Issue 6 Pg. 1752-8 (Jun 2002) ISSN: 0003-4975 [Print] Netherlands
• PMID: 12078765 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Acute Disease
• Adolescent
• Adult
• Cardiac Surgical Procedures (adverse effects)
• Child
• Child, Preschool
• Female
• Humans
• Incidence
• Infant
• Infant, Newborn
• Male
• Nervous System Diseases (epidemiology, etiology)
• Retrospective Studies