Cardiopulmonary Bypass Surgery in Children: Minimizing the Incidence of Postoperative Junctional Ectopic Tachycardia after Surgical Technique Modification

Azhar, Ahmad Saeed
January 2012
American Journal of Biomedical Sciences;Jan2012, Vol. 4 Issue 1, p79
Academic Journal
Background: Mechanical injury to tissues in and surrounding the Atrioventricular node is considered a major factor in the aetiology of postoperative Junctional Ectopic Tachycardia (JET). Objectives: The study aims to evaluate the effect of retractor modification used during cardiopulmonary bypass surgery and the incidence of postoperative JET in children. Material & Methods: The study involves retrospective chart review of all pediatric patients who had undergone cardiopulmonary bypass surgery in Children Hospital of Eastern Ontario, Canada, between 1993 and 1996. Patients treated between 1993 to 1994 with wide eyelid retractor (depth 23mm; width 18 mm) were classified as Group A, and the patients treated with narrow retractor (depth 10 mm; width 8 mm) between 1995 to 1996 were classified as Group B, respectively. Results: Of the study subjects, Group A had 209 while Group B had 186 subjects. The age and weight of group A subjects was "mean ± standard deviation" (4.4±4.1 year and 17±12 kg), while that of Group B was (4.7±4.7 year and 20±15 kg). The overall incidence of postoperative JET and mortality was lower in Group B than Group A (2% vs. 10%; p=0.0008; 0% vs. 21%; p<0.05, respectively). Conclusion: A decrease in the incidence of JET and mortality was noticed after the use of narrow retractor.


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