303: SINGLE-VENTRICLE POSTOPERATIVE OUTCOMES BASED ON PARAMETRIC DATA

Abstract

Introduction: The Bidirectional Glenn (BDG) operation is an important staging procedure for single ventricle physiology. Mortality rates after the BDG operation are low. Despite low mortality, the morbidity remains high and variable. Optimal physiologic targets in the postoperative period are yet known. This study aims to compare postoperative physiologic parameters after the BDG operation between patients with and without postoperative complications. Methods: This is a single-center retrospective cohort study of patients after the BDG operation. Data was collected from the medical records and Society of Thoracic Surgeons (STS) database. Postoperative data was acquired from Phillips Intellivue MX700 monitors. The target outcome was mortality or postoperative complication. Complications were labeled as medical, surgical, or both medical and surgical. Patient measurements were averaged hourly and then averaged hourly for the two groups. Student’s t-test (p< 0.001) was performed. Significant parameters were analyzed over 24 hour periods. Non-paired Student’s t-tests and Fisher’s exact tests (p< 0.05) were used for demographic and preoperative data. Results: Twenty-four patients underwent the BDG operation. Eight patients had no complications and 16 had postoperative complications. Four patients had only surgical complications and were excluded. There were no differences in characteristic, preoperative cardiac catheterization or echocardiographic data among the two groups. End-Tidal Carbon Dioxide was lower in patients with complications (33.1+/-2.7% vs 39.7+/-4.0%; p< 0.001); becoming different by 48 hours. Patients with complications had higher breaths per minute (BrPM) (33.4+/-4.14 BrPM vs 29.3+/-2.55 BrPM; p< 0.001). This difference was apparent by 48 hours. pH was higher in patients with complications (7.38+/-0.05 vs 7.33+/-0.07; p< 0.001) and became significant by 72 hours. Arterial carbon dioxide was lower in patients with complications (42.8+/-6.64mmHg vs. 53.6+/-10.42mmHg; p< 0.001), and became significant by 72 hours. Conclusions: This study demonstrates that physiologic data can serve as an early indicator for which postoperative BDG patients develop complications. Our data suggests that relative alkalosis with hypocarbia are associated with increased postoperative complications after BDG surgery.