Incidence of Gastrointestinal Complications in Pediatric Patients with Congenital Heart Disease Following Open-Heart Surgery: A Retrospective Study in Iran

Abstract

Background: Gastrointestinal (GI) complications are a significant but less explored issue in pediatrics with congenital heart disease (CHD) undergoing open-heart surgery. Objectives: This study aimed to assess the incidence, types, and associated risk factors for GI complications in pediatric patients with CHD following open-heart surgery. Methods: A retrospective analysis was conducted on 441 pediatric patients who underwent open-heart surgery between 2021 and 2022 at the Children’s Medical Center Hospital, affiliated with Tehran University of Medical Sciences. Data on demographic and clinical variables, including age, gender, risk adjustment for congenital heart surgery (RACHS-1), cardiopulmonary bypass (CPB) duration, and ICU stay, were collected. Data were analyzed in SPSS version 21 using descriptive and inferential statistics. A significance level of 0.05 was considered. Results: The incidence of GI complications was 10.4% (46 cases). Vomiting (34.78%) and chylothorax (23.91%) were the most frequent complications. Longer CPB duration (P = 0.002) and extended ICU stays (P < 0.001) were significantly associated with GI complications. No significant associations were found with age, gender, and RACHS-1 scores. Conclusions: Gastrointestinal complications, with an incidence of 10.4%, are a significant postoperative concern in pediatric patients undergoing open-heart surgery. Vomiting and chylothorax were the most frequent complications. Longer CPB duration was identified as a significant risk factor. Additionally, extended ICU stays may be a consequence of GI complications. These findings underscore the need to identify interventions for the early detection and management of GI complications.