Long-term outcomes after pediatric cardiac surgery: A 20-year single-institution study

Purpose: This study evaluated the long-term outcomes and factors associated with survival in patients undergoing cardiac surgery with cardiopulmonary bypass at a children’s cardiac center. Methods: A retrospective cohort study was conducted between 2001 and 2020 Outcomes included early or late survival and associated risk factors for survival. Results: Survival had a mean of 16.78 years (95% CI 16.50–17.06). The survival rates at 1, 5, 10, and 19 years were 91, 88, and 88%, respectively. Cox regression analysis indicated that age HR = 0.39, 95% CI [0.26–0.59], the RACHS-1 scale HR = 9.92, 95% CI [3.67–26.79], open chest HR = 1, 90, 95% CI [1.20–3.00], cardiac arrest HR = 3.91, 95% CI [2.40–6.36] and peritoneal dialysis HR = 6.71, 95% CI [4, 33–10.38], were independently associated with worse survival. Conclusions: long-term survival of children who undergo cardiac surgery at our single center was satisfactory. Age, higher RACHS score, delayed sternal closure, cardiac arrest, and peritoneal dialysis were strong predictors of adverse outcomes affecting early and long-term survival of pediatric cardiac surgery.