Implications of Transfusion in Adults with Congenital Heart Disease Undergoing Cardiac Surgery

AbstractThe number of adults with congenital heart disease (CHD) requiring cardiovascular (CV) surgery is increasing rapidly in today ’s era. We hypothesized that exposure to perioperative blood products is associated with worse outcomes in adults. All adults (≥ 18 years old) undergoing CV surgery with Cardio-Pulmonary Bypass (CPB) between 2015 and 2020 were reviewed retrospectively. Associations between transfusion and out comes were studied by univariable logistic regression and Wilcoxon rank sum tests. Cox/ logistic regression was used to assess (a) postoperative ventilation time and length of stay, and (b) major complications, respectively. Of 323 patients, 170 (53%) received blood products perioperatively. The med ian age was 27 (interquartile range [IQR]: 22–36) years, there were 181 (46%) males, and 16 (5%) patients had single ventricle anatomy. Patients receiving products experienced more complications (OR: 6.6, 95% CI: [2.9, 14.7],p <  0.001) specifically, cardiac arrest (OR: 8.8, 95% CI: [1.1, 71.9],p = 0.04). Transfusion was associated with greater frequency of thrombosis ((OR: 7.8, 95% CI: [1.8, 34.7],p = 0.01)), longer ventilation time (HR: 3.0, 95% CI: [2.4, 3.9],p <  0.001), and longer hospital length of stay (HR: 2.7, 95% CI: [2.1, 3.4],p <  0.001). Longer CPB time (OR: 1.0, 95% CI: [1.0, 1.1],p <  0.001) and prior cardiac surgery (OR: 1.6, 95% CI: [1.3, 2.1],p <  0.001) were independent predictors of periope...
Source: Mammalian Genome - Category: Genetics & Stem Cells Source Type: research