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interventricular septal hematoma after Congenital Cardiac Defects Repair at a Single Institution

Congenital Heart Disease 2022年第6期17卷 687-695页

作者： Yuan Hu Xiaohui Yang Jie Dong Peng Huang Jinwen Luo Guangxian Yang James D.StLouis Xicheng Deng Department of Echocardiography and Ultrasound Hunan Children’s HospitalChangshaChina Heart Center Hunan Children’s HospitalChangshaChina Pediatrics Research Institute of Hunan Province Hunan Children’s HospitalChangshaChina Departments of Surgery and Pediatrics Children’s Hospital of GeorgiaAugusta UniversityAugustaGeorgiaUSA

Background: interventricular septal hematoma is a rare complication after congenital cardiac repair. The managementvaries according to the literature. We present our experience with this rare complication. Methods:Echocardiography database were reviewed with the term ‘‘hematoma’’ or “hypoechoic mass” for patients whounderwent congenital heart surgery from January 2018 to December 2021 at our institution to identify potentialinterventricular septal hematoma cases. Relevant data of the patients identified were collected. Focus was put onthe presentation, management, outcomes according to patent medical charts and serial echocardiographic reportdata. Results: In total, there were 5 patients included. The mean age and weight at surgery were 5.5 ± 3.6 monthsand 5.5 ± 1.4 kg, respectively. Four patients were diagnosed with ventricular septal defect and the other one beingdouble outlet of the right ventricle. While all patients had intraoperative transesophageal echocardiography, 80%(4 of 5) of interventricular septal hematoma were revealed intraoperatively. Only one patient received hematomadrainage intraoperatively while the other 3 identified in the operating room were only closely observed. One afterventricular septal defect repair presented continuous dysfunction of the left ventricle at the last follow-up, whilethe others were doing well. All hematomas resolved completely with a mean time to interventricular septal hematomaresolution of 35.8 ± 16.9 days. Conclusion: Infants seem to be at a higher risk for interventricular septalhematoma following congenital heart surgery. While the majority of interventricular septal hematoma has abenign postoperative course, some may result in ventricular dysfunction. Management strategies may be chosenon a case-by-case basis.

关键词： interventricular septal hematoma ventricular septal defect double outlet right ventricle transesophageal echocardiography high-pressure waterjet

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