(203) Outcomes of Pediatric Cardiac Surgeries at a Brazilian Private Quaternary Hospital Without ECMO

Introduction: Pediatric cardiac surgeries are complex procedures that require specialized care and expertise. This study aims to analyze the outcomes of such surgeries at a Brazilian private quaternary hospital without ECMO support between January 2023 and June 2024. Understanding the factors influencing patient outcomes in this setting is crucial for improving surgical strategies and patient care.

Methods: A retrospective analysis was conducted on 69 pediatric patients who underwent cardiac surgeries at the hospital during the specified period. Data on surgical procedures, RACHS categories, cardiopulmonary bypass utilization, length of ICU stay, mortality rates, demographics, and comorbidities were collected and analyzed. The study aimed to assess the impact of surgical complexity on patient outcomes and identify any trends or associations.

Results: Among 69 patients, 63 underwent cardiac surgeries, while 6 were referred to external facilities due to the complexity of their conditions. The surgeries were categorized based on the RACHS system, with 53 procedures involving cardiopulmonary bypass and 10 performed without it. The length of stay in the ICU varied across different RACHS categories, ranging from 4.9 days for RACHS 1 to 19.5 days for RACHS 5. Mortality rates also varied, with no deaths reported in RACHS 1 and RACHS 4 categories, and one death each in RACHS 2, RACHS 3, and RACHS 5 categories. Additionally, two deaths were recorded in the RACHS 6 category, both occurring in the operating room. The demographic distribution revealed that 36 patients were female, accounting for 57.1% of the study population, while 27 patients were male. Comorbidities such as Down syndrome were present in 19 patients (30%), and DiGeorge syndrome was observed in 3 patients (4.7%). RACHS 6 was strongly associated with mortality (p < 0.001)

Conclusions: The findings highlight the importance of considering surgical complexity and patient characteristics in predicting outcomes of pediatric cardiac surgeries. The variations in mortality rates, length of ICU stay, and comorbidities underscore the need for tailored approaches to patient care and resource allocation. The study contributes to the existing literature on pediatric cardiac surgery outcomes and informs future strategies for improving patient outcomes in this setting.