[Operative results in cardiovascular surgery of the neonate].

Rev Invest Clin 2012 Mar-Apr;64(2):199-206

Departamento de Cirugía Cardiaca Pediátrica y Cardiopatías Congénitas, Instituto Nacional de Cardiología Ignacio Chávez.

Objective: To present our institutional postoperative results in cardiovascular surgery of the neonate, and to give an idea of its contribution to the national problematic knowledge in this area.

Material And Methods: A retrospective, descriptive, and observational study was carried out, including all neonates with congenital heart disease who were operated at the Ignacio Chávez National Cardiology Institute in a 7 year period. We made special emphasis in postoperative morbidity and mortality, as well as in the risk factors for early mortality.

Results: We operated on 484 neonates with congenital heart disease due to total anomalous pulmonary venous conection, classic transposition of great arteries, pulmonary atresia, and aortic coarctation. Causes for early mortality were cardiac failure, pulmonary hypertension, pulmonary sepsis, and arrhythmias. Operative mortality was 12.2% and was due mainly to congenital heart disease with 5 and 6 RACHS-1 risk score. Risk factors for operative mortality were: age < 15 days, body surface area < 0.20 m2, weight < 4 kg, and univentricular heart physiology.

Conclusions: There is still a high operative mortality for complex neonatal heart disease in this series. Our institutional outcomes can not be extrapolated to the rest of the country, but highlights several challenges that national pediatric health care institutions and associations must assume in order to improve the attention that neonatal patients demand.

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October 2012
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