Intraoperative Cardiac Events in Pediatric Patients with Congenital Heart Disease Undergoing Noncardiac Procedures: Analysis of a Large Multicenter Registry
Authors' conclusion
Pediatric patients with severe CHD, those undergoing emergency procedures, and those undergoing surgical interventions were at higher risk of not only mortality as shown previously but also hemodynamic instability.
Study context
- Population
- Patients with congenital heart disease (CHD), birth to 21 yr, undergoing noncardiac procedures, January–December 2021
- Participants
- 4,343 patients · 7 centres
- Outcome
- Intraoperative cardiac event per encounter:
- Intraoperative hemodynamic instability
- Cardiac arrest
- Pulmonary hypertensive crisis
Main finding
As reported in the abstract
Intraoperative cardiac event
Procedures with an intraoperative cardiac event (335 of 6,455; 296 unique patients)
5.2%
Hypotension, most common event (n = 315)
4.9%
Cardiac arrest (12 occurrences)
0.2%
Observational data: associations, not effects.
Further findings
Risk factors for intraoperative cardiac events (univariate analysis)
| OR (95% CI) | P value | ||
|---|---|---|---|
| PrematurityUnivariate analysis | 1.34 (1.02–1.76) | P = 0.038 | |
| Gastrointestinal chronic medical conditionUnivariate analysis | 1.51 (1.15–1.99) | P = 0.003 | |
| Respiratory chronic medical conditionUnivariate analysis | 2.12 (1.62–2.76) | P < 0.001 | |
| Preoperative ventilatory supportUnivariate analysis | 3.88 (2.8–5.38) | P < 0.001 | |
| Concurrent respiratory illnessUnivariate analysis | 2.18 (1.47–3.2) | P < 0.001 | |
| Major CHDUnivariate analysis | 2.09 (1.54–2.83) | P < 0.001 | |
| Severe CHDUnivariate analysis | 3.48 (2.47–4.91) | P < 0.001 | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Intraoperative Cardiac Events in Pediatric Patients with Congenital Heart Disease Undergoing Noncardiac Procedures: Analysis of a Large Multicenter Registry. Anesthesiology. Published 3 October 2025. doi:10.
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