Congenital heart diseaseCohort study
Sinus node dysfunction after surgery for congenital heart disease: Incidence and impact on recovery
- retrospective study
Authors' conclusion
SND occurs in more than 25% of surgeries involving pulmonary veins, mitral valve, atrial baffle creation, and Glenn and Fontan palliation. Stage 1 palliation frequently requires pacing for hemodynamic needs. SND persists at discharge in 11% and is associated with worse postoperative outcomes. Permanent atrial pacing need was found in 2% of all surgeries with postoperative SND.
Study context
- Population
- Children aged 0–18 years after cardiac surgery for congenital heart disease in 2013–2017
- Participants
- 4,571 surgeries
- Exposure
- Postoperative outcomes were compared in surgeries with no postoperative sinus node dysfunction (SND), absolute SND, and relative SND.
- absolute SNDn = 695
- relative SNDn = 91
Main finding
As reported in the abstract
SND occurred in surgeries
786 surgeries (17.2%)
absolute SND
695
relative SND
91
Observational data: associations, not effects.
Further findings
Absolute SND by surgery type
- surgery involving pulmonary veins
- 31%
- mitral valve
- 27%
- atrial baffle creation
- 27%
- Glenn palliation
- 26%
- Fontan palliation
- 26%
Relative SND by surgery type
- stage 1 palliation
- 10%
Recovery from SND · before discharge
- surgeries recovered from SND before discharge
- 89%
- median recovery time
- 31.9 hours
Postoperative outcomes with SND
- Surgeries with SND had longer hospital and intensive care unit length of stay, longer time to extubation, and a higher incidence of major adverse cardiac events
Original publication
Summarised from the published abstract; every number is checked against it