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Beta-blocker use after complete repair of tetralogy of Fallot: an analysis of a national database

Part of: Surgery

Published online by Cambridge University Press:  08 July 2021

Enrique G. Villarreal Open the ORCID record for Enrique G. Villarreal [Opens in a new window] ,
Juan S. Farias ,
James S. Tweddell ,
Rohit S. Loomba Open the ORCID record for Rohit S. Loomba [Opens in a new window]  and
Saul Flores Open the ORCID record for Saul Flores [Opens in a new window]
Enrique G. Villarreal*
Affiliation:
Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico
Juan S. Farias
Affiliation:
Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico
James S. Tweddell
Affiliation:
Cincinnati Children’s Hospital Medical Center, The Heart Center, Cincinnati, OH, USA
Rohit S. Loomba
Affiliation:
Cardiology, Pediatrics, Advocate Children’s Hospital, Oak Lawn, IL, USA Medicine, Chicago Medical School/Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
Saul Flores
Affiliation:
Texas Children’s Hospital, Section of Critical Care and Cardiology/Baylor College of Medicine, Houston, TX, USA
*
Author for correspondence: Enrique G. Villarreal, MD, Department of Pediatrics, Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico. Tel: +5218113244817. E-mail: quique_villarreal93@hotmail.com
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Abstract

Introduction:

In patients with right ventricular diastolic dysfunction after complete repair of tetralogy of Fallot, some employ the use of beta-blockade. The theoretical benefit of this therapy is felt to be one of the two: 1) reduction in heart rate with subsequent increase in diastolic filling time and stroke volume; 2) halting or reversal of right ventricular remodelling. This study aimed to characterise the use of beta-blockade in paediatric admissions with complete repair of tetralogy of Fallot and characterise the effects of beta-blockade on admission characteristics.

Methods:

Admissions from 2004 to 2015 in the Pediatric Health Information System database with complete repair of tetralogy of Fallot were identified. Characteristics between admissions with and without beta-blockade were compared by univariate analysis. Next, regression analyses were conducted to determine the independent association of beta-blockade on length of admission, billed charges, cardiac arrest, and inpatient mortality while controlling for demographic variables and comorbidities.

Results:

A total of 3594 admissions were included in the final analyses. Of these, 371 employed beta-blockade. Admissions with beta-blockade were more likely to have heart failure and tachyarrhythmias. These admissions also tended to be longer by univariate analysis. Regression analyses demonstrated that beta-blockade was independently associated with a 2.8-day increase in length of stay and no statistically significant change in billed charges, cardiac arrest, or inpatient mortality.

Conclusions:

Beta-blockade after complete repair of tetralogy of Fallot is associated with a longer length of stay but did not statistically significantly impact billed charges, cardiac arrest, or inpatient mortality.

Keywords

Tetralogy of Fallotadrenergic beta-antagonistsmortalitylength of stayCHDspaediatrics
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 4 , April 2022 , pp. 584 - 588
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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