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Outcomes from an interprovincial program of newborn open heart surgery
Charlene M T Robertson1, Ari R Joffe, Reginald S Sauve
1Departments of Pediatrics and Surgery, University of Alberta, Edmonton, Alberta, Canada. croberts@cha.ab.ca
Objectives:
To determine 18-month neurodevelopmental outcome of survivors of complex open heart surgery at
Results:
Survival of the 85 children included 23 of 23 after arterial switch, 16 of 26 after Norwood, six of six after total anomalous pulmonary venous drainage repair, and 22 of 30 after miscellaneous repair. Outcomes were as follows: in-hospital death, 14 (16%); postdischarge death, four (5%); motor/sensory disability, three (4%); motor/mental delay (<70), 21 (25%); and intact survivors, 43 (50%). Cohort mental (84+/-17) and motor (80+/-22) scores were lower for those with chromosomal abnormalities, 67+/-16 and 61+/-17, respectively. Fifty-five percent of the outcome variance was explained by duration of preoperative ventilation, 18%; genetic anomaly, 5%; intraoperative variables, 18%; and postoperative variables, 14%.
Conclusions:
Risk for adverse outcome is cumulative, with preoperative determinants contributing significantly to total variance. Potentially modifiable variables should be sought in an attempt to improve outcome.