Open Access

ARTICLE

Interventricular Septal Hematoma after Congenital Cardiac Defects Repair at a Single Institution

by Yuan Hu¹, Xiaohui Yang², Jie Dong³, Peng Huang², Jinwen Luo², Guangxian Yang², James D. St. Louis⁴, Xicheng Deng^2,*

1 Department of Echocardiography and Ultrasound, Hunan Children’s Hospital, Changsha, China
2 Heart Center, Hunan Children’s Hospital, Changsha, China
3 Pediatrics Research Institute of Hunan Province, Hunan Children’s Hospital, Changsha, China
4 Departments of Surgery and Pediatrics, Children’s Hospital of Georgia, Augusta University, Augusta, Georgia, USA

* Corresponding Author: Xicheng Deng. Email:

Congenital Heart Disease 2022, 17(6), 687-695. https://doi.org/10.32604/chd.2022.024333

Received 04 July 2022; Accepted 14 September 2022; Issue published 11 October 2022

Abstract

Background: Interventricular septal hematoma is a rare complication after congenital cardiac repair. The management varies 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 who underwent congenital heart surgery from January 2018 to December 2021 at our institution to identify potential interventricular septal hematoma cases. Relevant data of the patients identified were collected. Focus was put on the presentation, management, outcomes according to patent medical charts and serial echocardiographic report data. Results: In total, there were 5 patients included. The mean age and weight at surgery were 5.5 ± 3.6 months and 5.5 ± 1.4 kg, respectively. Four patients were diagnosed with ventricular septal defect and the other one being double 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 hematoma drainage intraoperatively while the other 3 identified in the operating room were only closely observed. One after ventricular septal defect repair presented continuous dysfunction of the left ventricle at the last follow-up, while the others were doing well. All hematomas resolved completely with a mean time to interventricular septal hematoma resolution of 35.8 ± 16.9 days. Conclusion: Infants seem to be at a higher risk for Interventricular septal hematoma following congenital heart surgery. While the majority of interventricular septal hematoma has a benign postoperative course, some may result in ventricular dysfunction. Management strategies may be chosen on a case-by-case basis.

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