Methods: A total of 18 patients (10 girls, 8 boys; mean age 9.4±10.5 months; range 2 to 42 months) who were hospitalized in the pediatric cardiac intensive care unit at a single center between January 2010 and January 2015 and who underwent tracheostomy during the hospitalization period were retrospectively analyzed.

Results: At baseline, genetic disorders were identified in three patients. Among 1,450 patients who underwent cardiac surgery, 10 received total correction and eight received palliation. The mean intubation time without tracheostomy was 41.0±12.9 days and the number of extubation attempts was 4.2±0.8. Two patients had neurological damage. No patients developed pneumomediastinum, pneumothorax, wound site infection or mediastinitis following tracheostomy. One patient underwent revision of the tracheostomy site due to bleeding. None of the patients had late tracheostomy complications such as tracheal stenosis during the follow-up period. Six of 18 tracheostomy patients died in the pediatric cardiac intensive care unit and one died at home following discharge (mortality 38.8%). Eight of 12 tracheostomy patients who were discharged underwent decannulation. Three patients are currently under follow-up at home using a home-type ventilator.

Conclusion: Tracheostomy procedures may be performed in patients with prolonged intubation time following cardiac surgery with a low complication rate. However, the morbidity and mortality rates in this patient population still remain high due to several factors implicated in this complicated process.