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The Impact of Concomitant Left Ventricular Non-compaction with Congenital Heart Disease on Perioperative Outcomes

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Abstract

Left ventricular non-compaction (LVNC) is a heterogeneous myocardial disorder characterized by prominent trabeculations and inter-trabecular recesses which may occur in association with congenital heart disease (CHD). To date, few studies have been performed to assess whether the concomitant diagnosis of LVNC affects the outcomes of CHD surgery. A retrospective review of patients with LVNC with CHD (LVNC-CHD), 0–5 years of age, was conducted. Patients with CHD without LVNC (CHD-only) and 0–5 years of age with similar diagnosis distribution were selected for comparison. Perioperative data, including CHD diagnosis, operative course, and postoperative complications were collected and compared between groups. LVNC-CHD was diagnosed in 26 children. Of the 26 with LVNC-CHD, 20 underwent surgery and these patients were compared with 276 CHD-only controls. Median total length of stay in the hospital was 12.5 days (IQR 5.5–63 days) in LVNC-CHD compared to 5 days (IQR 3–10 days) in CHD-only (p < 0.005). Postoperative death, cardiac arrest, or need for ECMO or transplantation occurred in 6/20 (30 %) of the LVNC-CHD patients compared to 3/276 (1 %) of the CHD-only group (p < 0.0001). LVNC-CHD patients had significantly longer hospital length of stay and higher perioperative complications compared to CHD-only patients without myocardial abnormalities. Pediatric cardiac care teams should be cognizant of the possibility of the increased perioperative risk associated with concomitant LVNC. Future prospective studies are warranted.

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Authors and Affiliations

  1. The Heart Institute, Cincinnati Children’s Hospital, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA

    Preeti Ramachandran, Thomas D. Ryan, Haleh C. Heydarian, John L. Jefferies & Angela Lorts

  2. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital, Cincinnati, OH, USA

    Jessica G. Woo

  3. Cardiothoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Roosevelt Bryant

  4. The Heart Institute, Le Bonheur Children’s Hospital, Memphis, TN, USA

    Jeffrey A. Towbin

Authors
  1. Preeti Ramachandran
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  2. Jessica G. Woo
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  3. Thomas D. Ryan
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  4. Roosevelt Bryant
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  5. Haleh C. Heydarian
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  6. John L. Jefferies
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  7. Jeffrey A. Towbin
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  8. Angela Lorts
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Correspondence to Preeti Ramachandran.

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The authors declare that they have no conflicts of interest.

Additional information

Dr. Jeffrey A. Towbin and Dr. John L. Jefferies are funded by the NIH-NHLBI Pediatric Cardiomyopathy Registry (PCMR; 2RO1 HL53392-06A1 and 1R01 HL109090-01).

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Ramachandran, P., Woo, J.G., Ryan, T.D. et al. The Impact of Concomitant Left Ventricular Non-compaction with Congenital Heart Disease on Perioperative Outcomes. Pediatr Cardiol 37, 1307–1312 (2016). https://doi.org/10.1007/s00246-016-1435-2

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  • DOI: https://doi.org/10.1007/s00246-016-1435-2

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