Unplanned reinterventions following surgical palliation for single ventricle heart disease may influence clinical outcomes. Data from the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) database were analyzed to identify risk factors for unplanned reintervention after Stage 2 palliation and associated outcomes. Multivariate regression models were used to evaluate predictors and outcome associations. The study was published in The Annals of Thoracic Surgery.

Among 2095 patients undergoing Stage 2 palliation, 401 (19.1%) experienced an unplanned reintervention. Of these, 247 (11.8%) involved interventional catheterization only, 78 (3.7%) surgery only, and 76 (3.6%) both catheterization and surgical procedures. Risk factors for unplanned reintervention included hybrid procedure as Stage 1 (OR 1.8; 95%CI 1.1-3.1), prior reintervention after Stage 1, tube feeding at Stage 2 (OR 1.9; 95%CI 1.4–2.5), and additional cardiac procedures during Stage 2 surgery (OR 1.9; 95%CI 1.5-2.5).

Patients undergoing both surgical and catheter-based reinterventions had a median 21-day longer hospital stay (95% CI 14.5-27.5) and higher odds of additional reinterventions between Stage 2 discharge and the first birthday (OR 3.8; 95% CI 2.0-7.2). Any reintervention was associated with reduced transplant-free survival (HR 2.2; 95%CI 1.4-3.5).

Unplanned reinterventions were associated with increased morbidity and reduced transplant-free survival. Identified risk factors may represent potential targets for outcome improvement.