Congenital Heart Surgery Outcomes in Patients with Positive Respiratory Viral Swabs

OBJECTIVE:To examine whether viral positive patients experienced worse outcomes and assess differences in surgical outcomes between viral positive patients with and without viral symptoms within 30 days of surgery. METHODS:This retrospective study reviewed charts of pediatric patients who underwent congenital heart surgery and routine viral testing at a single institution over a consecutive 3-year period (2017-2019). Patients with a history of heart transplants, pacemaker changes or implants, and mediastinal washouts were excluded from the study. Surgical outcomes were compared by viral status and viral symptoms, using the Fisher exact and Wilcoxon rank sum tests. RESULTS:Among1041 patients, 374 patients underwent routine preoperative viral testing, with 107 patients testing positive and 267 testing negative for viral swabs prior to surgery. There were no significant differences observed in surgical outcomes by viral status including no differences in mortality. Among the 107 patients with positive viral swabs prior to surgery, comparisons between 24 patients with viral symptoms and 83 without symptoms within 30 days of surgery detected no significant differences in mortality or complication rates. However, symptomatic vs. asymptomatic patients had significantly longer postoperative stay (23.4 vs. 13.4 days, p=0.02) and intubation time (9.8 vs. 4.9 hours, p=0.004). CONCLUSION:Patients who test positive prior to congenital heart surgery and are asymptomatic beyond the incubation period may proceed to surgery with no further delay. Patients who are viral positive and symptomatic have a longer postoperative stay and intubation time. A prospective study is needed to assess the importance of routine viral testing.