Impact of Genetic Anomalies on Postoperative Hemodynamics and Clinical Outcomes After Congenital Heart Surgery

Objectives: Genetic anomalies are frequently associated with congenital heart disease and may influence postoperative outcomes after pediatric cardiac surgery. However, their relationship with postoperative hemodynamic severity remains incompletely characterized. This study aimed to evaluate postoperative clinical burden and hemodynamic severity in pediatric patients with congenital heart disease and genetic anomalies who underwent cardiac surgery.
Methods: This retrospective, single-center cohort study included pediatric patients who underwent surgery for congenital heart disease during a two-year study period. Patients were classified according to the presence or absence of documented genetic anomalies. Demographic, operative, and postoperative variables, including the vasoactive–inotropic score (VIS), cross-clamp duration, mechanical ventilation duration, intensive care unit (ICU) length of stay, hospital length of stay, extracorporeal membrane oxygenation (ECMO) requirement, dialysis requirement, delayed sternal closure, reintubation, and in-hospital mortality, were analyzed.
Results: A total of 1,456 pediatric patients were included, including 86 patients with documented genetic anomalies. Patients with genetic anomalies demonstrated significantly greater postoperative hemodynamic severity and resource utilization. Median VIS values were sig-nificantly higher in the genetic anomaly group (17.0 [12.0–22.0] vs. 13.0 [8.0–17.0], p=0.003). Cross-clamp duration (p=0.027), mechanical ventilation duration (p=0.007), ICU length of stay (p=0.007), and hospital length of stay (p=0.002) were significantly prolonged. Mortality was numerically higher among patients with genetic anomalies, although statistical significance was not reached.
Conclusions: Pediatric patients with congenital heart disease and genetic anomalies who undergo cardiac surgery represent a clinically vul-nerable subgroup characterized by greater postoperative hemodynamic severity and increased healthcare resource utilization. Recognition of this phenotype may facilitate intensified perioperative monitoring and earlier supportive interventions.

Keywords: Congenital heart surgery, genetic anomalies, pediatric cardiac intensive care, postoperative outcomes, vasoactive–inotropic score