Tracheostomy Following Surgery for Congenital Heart Disease: A 14-year Institutional Experience

Brian D. Benneyworth, Jenny M. Shao, A. Ioana Cristea, Veda Ackerman, Mark Rodefeld, Mark Turrentine, John Brown

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: Tracheostomy following congenital heart disease (CHD) surgery is a rare event and associated with significant mortality. Hospital survival has been reported from 20% to 40%. Late mortality for these patients is not well characterized.

METHODS: We performed a retrospective observational study of patients who had a tracheostomy following CHD surgery (excluding isolated patent ductus arteriosus ligation) between January 2000 and December 2013. Patients were categorized into single-ventricle or biventricular physiology groups. Demographics, genetic syndromes, pulmonary disease, and comorbidities were collected. Outcomes including hospital survival, long-term survival, and weaning from positive pressure ventilation are reported. Bivariate and time-to-event models were used.

RESULTS: Over a 14-year period, 61 children (0.9% incidence) had a tracheostomy placed following CHD surgery. There were 12 single-ventricle patients and 49 biventricular patients. Prematurity, genetic syndromes, lung/airway disease, and other comorbidities were common in both CHD groups. Gastrostomy tubes were used more frequently in biventricular physiology patients (91.8%) versus single-ventricle patients (66.7%, P = .04). Survival to hospital discharge was 50% in the single-ventricle group compared to 86% in biventricular patients (P = .01). Long-term survival continued to be poor in the single-ventricle group comparatively (three years, 27.8% vs 64.8%, P = .01). Gastrostomy tube placement was independently associated with survival in both groups (P = .002).

CONCLUSION: Tracheostomy is performed following many types of surgery for CHD and is commonly associated with other comorbidities. Both hospital and long-term survival are substantially lower in children with single-ventricle physiology as compared to patients with biventricular physiology.

Original languageEnglish (US)
Pages (from-to)360-366
Number of pages7
JournalWorld journal for pediatric & congenital heart surgery
Volume7
Issue number3
DOIs
StatePublished - May 1 2016

Fingerprint

Tracheostomy
Heart Diseases
Survival
Thoracic Surgery
Comorbidity
Gastrostomy
Lung Diseases
Patent Ductus Arteriosus
Positive-Pressure Respiration
Mortality
Weaning
Observational Studies
Ligation
Retrospective Studies
Demography
Incidence

Keywords

  • complications
  • congenital heart disease (CHD)
  • morbidity)
  • outcomes (includes mortality
  • statistics
  • surgery
  • survival analysis
  • tracheostomy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Tracheostomy Following Surgery for Congenital Heart Disease : A 14-year Institutional Experience. / Benneyworth, Brian D.; Shao, Jenny M.; Cristea, A. Ioana; Ackerman, Veda; Rodefeld, Mark; Turrentine, Mark; Brown, John.

In: World journal for pediatric & congenital heart surgery, Vol. 7, No. 3, 01.05.2016, p. 360-366.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Tracheostomy following congenital heart disease (CHD) surgery is a rare event and associated with significant mortality. Hospital survival has been reported from 20{\%} to 40{\%}. Late mortality for these patients is not well characterized.METHODS: We performed a retrospective observational study of patients who had a tracheostomy following CHD surgery (excluding isolated patent ductus arteriosus ligation) between January 2000 and December 2013. Patients were categorized into single-ventricle or biventricular physiology groups. Demographics, genetic syndromes, pulmonary disease, and comorbidities were collected. Outcomes including hospital survival, long-term survival, and weaning from positive pressure ventilation are reported. Bivariate and time-to-event models were used.RESULTS: Over a 14-year period, 61 children (0.9{\%} incidence) had a tracheostomy placed following CHD surgery. There were 12 single-ventricle patients and 49 biventricular patients. Prematurity, genetic syndromes, lung/airway disease, and other comorbidities were common in both CHD groups. Gastrostomy tubes were used more frequently in biventricular physiology patients (91.8{\%}) versus single-ventricle patients (66.7{\%}, P = .04). Survival to hospital discharge was 50{\%} in the single-ventricle group compared to 86{\%} in biventricular patients (P = .01). Long-term survival continued to be poor in the single-ventricle group comparatively (three years, 27.8{\%} vs 64.8{\%}, P = .01). Gastrostomy tube placement was independently associated with survival in both groups (P = .002).CONCLUSION: Tracheostomy is performed following many types of surgery for CHD and is commonly associated with other comorbidities. Both hospital and long-term survival are substantially lower in children with single-ventricle physiology as compared to patients with biventricular physiology.",
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AU - Benneyworth, Brian D.

AU - Shao, Jenny M.

AU - Cristea, A. Ioana

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AU - Rodefeld, Mark

AU - Turrentine, Mark

AU - Brown, John

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N2 - BACKGROUND: Tracheostomy following congenital heart disease (CHD) surgery is a rare event and associated with significant mortality. Hospital survival has been reported from 20% to 40%. Late mortality for these patients is not well characterized.METHODS: We performed a retrospective observational study of patients who had a tracheostomy following CHD surgery (excluding isolated patent ductus arteriosus ligation) between January 2000 and December 2013. Patients were categorized into single-ventricle or biventricular physiology groups. Demographics, genetic syndromes, pulmonary disease, and comorbidities were collected. Outcomes including hospital survival, long-term survival, and weaning from positive pressure ventilation are reported. Bivariate and time-to-event models were used.RESULTS: Over a 14-year period, 61 children (0.9% incidence) had a tracheostomy placed following CHD surgery. There were 12 single-ventricle patients and 49 biventricular patients. Prematurity, genetic syndromes, lung/airway disease, and other comorbidities were common in both CHD groups. Gastrostomy tubes were used more frequently in biventricular physiology patients (91.8%) versus single-ventricle patients (66.7%, P = .04). Survival to hospital discharge was 50% in the single-ventricle group compared to 86% in biventricular patients (P = .01). Long-term survival continued to be poor in the single-ventricle group comparatively (three years, 27.8% vs 64.8%, P = .01). Gastrostomy tube placement was independently associated with survival in both groups (P = .002).CONCLUSION: Tracheostomy is performed following many types of surgery for CHD and is commonly associated with other comorbidities. Both hospital and long-term survival are substantially lower in children with single-ventricle physiology as compared to patients with biventricular physiology.

AB - BACKGROUND: Tracheostomy following congenital heart disease (CHD) surgery is a rare event and associated with significant mortality. Hospital survival has been reported from 20% to 40%. Late mortality for these patients is not well characterized.METHODS: We performed a retrospective observational study of patients who had a tracheostomy following CHD surgery (excluding isolated patent ductus arteriosus ligation) between January 2000 and December 2013. Patients were categorized into single-ventricle or biventricular physiology groups. Demographics, genetic syndromes, pulmonary disease, and comorbidities were collected. Outcomes including hospital survival, long-term survival, and weaning from positive pressure ventilation are reported. Bivariate and time-to-event models were used.RESULTS: Over a 14-year period, 61 children (0.9% incidence) had a tracheostomy placed following CHD surgery. There were 12 single-ventricle patients and 49 biventricular patients. Prematurity, genetic syndromes, lung/airway disease, and other comorbidities were common in both CHD groups. Gastrostomy tubes were used more frequently in biventricular physiology patients (91.8%) versus single-ventricle patients (66.7%, P = .04). Survival to hospital discharge was 50% in the single-ventricle group compared to 86% in biventricular patients (P = .01). Long-term survival continued to be poor in the single-ventricle group comparatively (three years, 27.8% vs 64.8%, P = .01). Gastrostomy tube placement was independently associated with survival in both groups (P = .002).CONCLUSION: Tracheostomy is performed following many types of surgery for CHD and is commonly associated with other comorbidities. Both hospital and long-term survival are substantially lower in children with single-ventricle physiology as compared to patients with biventricular physiology.

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KW - surgery

KW - survival analysis

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