Tachyarrhythmias After the Norwood Procedure: Relationship and Effect of Vasoactive Agents

Tachyarrhythmias are common after the Norwood stage I palliation. The effects of vasoactive medications on the development of post-operative tachyarrhythmias have not been studied. The primary objective was to identify associations between postoperative tachyarrhythmias and vasoactive medication usa...

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Bibliographic Details
Published in:Pediatric cardiology 2014-04, Vol.35 (4), p.668-675
Main Authors: McFerson, Megan C., McCanta, Anthony C., Pan, Zhaoxing, Collins, Kathryn K., Jaggers, James, da Cruz, Eduardo M., Kaufman, Jon
Format: Article
Language:English
Subjects:
Analysis
Cardiac Surgery
Cardiology
Colorado
Colorado - epidemiology
Complications and side effects
Dose-Response Relationship, Drug
Electrocardiography
Epinephrine
Female
Follow-Up Studies
Heart Rate - drug effects
Humans
Hypoplastic Left Heart Syndrome - surgery
Incidence
Infant, Newborn
Length of Stay
Male
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Milrinone - administration & dosage
Milrinone - therapeutic use
Mortality
Norwood Procedures - adverse effects
Original Article
Postoperative Complications
Retrospective Studies
Survival Rate - trends
Tachycardia
Tachycardia - drug therapy
Tachycardia - epidemiology
Tachycardia - physiopathology
Treatment Outcome
Vascular Surgery
Vasodilator Agents - administration & dosage
Vasodilator Agents - therapeutic use
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Summary:Tachyarrhythmias are common after the Norwood stage I palliation. The effects of vasoactive medications on the development of post-operative tachyarrhythmias have not been studied. The primary objective was to identify associations between postoperative tachyarrhythmias and vasoactive medication usage after Norwood stage 1 palliation. Secondary objectives included evaluation for morbidities of tachyarrhythmias and for associations with anatomical or surgical variables. Retrospective chart review was performed on all patients who underwent the Norwood stage 1 palliation at Children’s Hospital Colorado between January 2008 and June 2012. Primary outcomes were development of postoperative tachyarrhythmias and the effects of vasoactive medications. Dopamine, epinephrine, milrinone, and vasopressin duration, cumulative dose, highest dose, and dose at onset of tachyarrhythmia were identified. The effects of surgical variables and anatomy were also studied. Sixty-six patients underwent the Norwood procedure, and 33 (50 %) of these patients had postoperative tachyarrhythmias. Patients with tachyarrhythmias had longer ICU stays ( p  = 0.02) and hospital stays ( p  
ISSN:0172-0643
1432-1971
DOI:10.1007/s00246-013-0836-8