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A retrospective study of perioperative clinical seizures and epilepsy in children after operation for CHD

Published online by Cambridge University Press:  28 December 2021

Takeshi Ikegawa Open the ORCID record for Takeshi Ikegawa [Opens in a new window] ,
Shin Ono Open the ORCID record for Shin Ono [Opens in a new window] ,
Kouji Yamamoto ,
Mikihiro Shimizu ,
Sadamitsu Yanagi ,
Ki-Sung Kim ,
Yasuhiro Ichikawa Open the ORCID record for Yasuhiro Ichikawa [Opens in a new window]  and
Hideaki Ueda
Takeshi Ikegawa
Affiliation:
Department of Cardiology, Kanagawa Children’s Medical Center, Kanagawa, Japan
Shin Ono*
Affiliation:
Department of Cardiology, Kanagawa Children’s Medical Center, Kanagawa, Japan
Kouji Yamamoto
Affiliation:
Department of Biostatistics, Yokohama City University School of Medicine, Kanagawa, Japan
Mikihiro Shimizu
Affiliation:
Department of Biostatistics, Yokohama City University School of Medicine, Kanagawa, Japan
Sadamitsu Yanagi
Affiliation:
Department of Cardiology, Kanagawa Children’s Medical Center, Kanagawa, Japan
Ki-Sung Kim
Affiliation:
Department of Cardiology, Kanagawa Children’s Medical Center, Kanagawa, Japan
Yasuhiro Ichikawa
Affiliation:
Department of Cardiology, Kanagawa Children’s Medical Center, Kanagawa, Japan
Hideaki Ueda
Affiliation:
Department of Cardiology, Kanagawa Children’s Medical Center, Kanagawa, Japan
*
Author for correspondence: S. Ono, Department of Cardiology, Kanagawa Children’s Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Kanagawa, Japan. Tel: +81-45-711-2351; Fax: +81-45-721-3324. E-mail: [email protected]
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Abstract

This study investigated the incidence and risk factors of perioperative clinical seizure and epilepsy in children after operation for CHD. We included 777 consecutive children who underwent operation from January 2013 to December 2016 at Kanagawa Children’s Medical Center, Kanagawa, Japan. Perinatal, perioperative, and follow-up medical data were collected. Elastic net regression and mediation analysis were performed to investigate risk factors of perioperative clinical seizure and epilepsy. Anatomic CHD classification was performed based on the preoperative echocardiograms; cardiac surgery was evaluated using Risk Adjustment in Congenital Heart Surgery 1. Twenty-three (3.0%) and 15 (1.9%) patients experienced perioperative clinical seizure and epilepsy, respectively. Partial regression coefficient with epilepsy as the objective variable for anatomical CHD classification, Risk Adjustment in Congenital Heart Surgery 1, and the number of surgeries was 0.367, 0.014, and 0.142, respectively. The proportion of indirect effects on epilepsy via perioperative clinical seizure was 22.0, 21.0, and 33.0%, respectively. The 15 patients with epilepsy included eight cases with cerebral infarction, two cases with cerebral haemorrhage, and three cases with hypoxic-ischaemic encephalopathy; white matter integrity was not found. Anatomical complexity of CHD, high-risk cardiac surgery, and multiple cardiac surgeries were identified as potential risk factors for developing epilepsy, with a low rate of indirect involvement via perioperative clinical seizure and a high rate of direct involvement independently of perioperative clinical seizure. Unlike white matter integrity, stroke and hypoxic-ischaemic encephalopathy were identified as potential factors for developing epilepsy.

Keywords

CHDperioperative clinical seizurecardiac surgeryepilepsy
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 11 , November 2022 , pp. 1807 - 1813
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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