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Open heart surgery in the first 24 hours of life
G Esposito1, B R Keeton, G R Sutherland
1Wessex Cardiothoracic Unit, General Hospital, Southampton, UK.
Insights
Infants can undergo successful open heart surgery within 24 hours of birth. This includes complex congenital heart defects, showing improved outcomes for neonatal cardiac surgery.
Area of Science:
- Pediatric Cardiac Surgery
- Neonatal Cardiology
- Congenital Heart Disease Treatment
Background:
- Outcomes for open heart surgery in infants have significantly improved.
- This progress encourages early corrective surgical interventions for neonates.
- Advancements in surgical techniques and perioperative care are key.
Observation:
- This study reports on four infants who underwent successful surgical correction within 24 hours of birth.
- Two neonates with total anomalous pulmonary venous drainage (TAPVD) were treated.
- One infant with pulmonary atresia and intact ventricular septum (PA/IVS) underwent correction.
- A fourth infant with aortic stenosis received surgical correction.
Findings:
- Successful surgical correction was achieved in all four neonates within the first day of life.
- Profound hypothermia using combined surface and bypass cooling was employed for TAPVD and PA/IVS repairs.
- Standard cardiopulmonary bypass techniques were sufficient for the aortic stenosis repair.
- The study demonstrates the feasibility of applying established surgical methods to extremely preterm infants.
Implications:
- Early surgical intervention for congenital heart defects in neonates is viable and effective.
- These findings support the expansion of neonatal cardiac surgery programs.
- Further research can focus on refining techniques for even earlier and more complex neonatal cardiac repairs.
Abstract:
The results of open heart surgery in infants have steadily improved. The performance of corrective surgery very early in life has thereby been encouraged. We report four patients who underwent successful surgical correction within 24 h of birth. Two patients with total anomalous pulmonary venous drainage and one patient with pulmonary atresia and intact septum were corrected with the aid of profound hypothermia by the combined surface and bypass cooling technique. Cardiopulmonary bypass alone was used for the fourth patient with aortic stenosis. The usual surgical techniques can be applied successfully to infants even within 24 h of life.