Factors Associated with Surgical Site Infection in Pediatric Patients Undergoing Minimally Invasive Surgery for Congenital Heart Disease at the Cardiovascular Center, E Hospital, in 2025

Surgical site infection (SSI) is a notable complication following congenital heart surgery in pediatric patients, which may prolong hospital stay, increase treatment costs, and negatively affect recovery outcomes. Minimally invasive cardiac surgery via the right axillary approach has been increasingly adopted due to its advantages, including reduced tissue trauma, shorter recovery time, and improved cosmetic outcomes. However, SSIs may still occur and are influenced by various clinical and postoperative care–related factors. Objective: To describe the incidence of surgical site infection and explore factors associated with SSI in pediatric patients undergoing minimally invasive surgery for congenital heart disease at the Cardiovascular Center – E Hospital in 2025. Methods: A prospective descriptive study was conducted on 111 pediatric patients aged ≤15 years who underwent minimally invasive cardiac surgery via the right axillary approach at the Cardiovascular Center – E Hospital from February to August 2025. Data were collected from medical records and postoperative clinical follow-up. Associations between variables and SSI were analyzed using Fisher’s exact test. Odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated. Results: The overall SSI rate was 5.41% (6/111 cases), and all cases were classified as superficial SSIs; no cases of deep incisional or organ/space infections were recorded. Univariate analysis showed that factors associated with SSI included complex congenital heart disease (p = 0.035), operative duration ≥180 minutes (p = 0.027), and postoperative hypoxemia with SpO₂ <92% (OR = 11.3; p = 0.009). Conclusion: The incidence of surgical site infection after minimally invasive cardiac surgery in pediatric patients at the Cardiovascular Center – E Hospital was relatively low and mainly consisted of superficial infections. However, the complexity of congenital heart disease, prolonged operative duration, and postoperative hypoxemia were statistically associated with SSI and may suggest a potential role in its risk. Close monitoring and optimization of postoperative care, particularly the maintenance of adequate tissue oxygenation, play an important role in preventing this complication.