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[Surgery of congenital cardiopathies without catheterization: initial experience with 141 consecutive cases]
Insights
This study on congenital heart disease surgery in 141 children found that hemodynamic and angiocardiographic studies are often unnecessary. Echocardiography and surgical findings correlated well, supporting a streamlined surgical approach.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
- Diagnostic Imaging
Background:
- Congenital heart disease (CHD) necessitates timely surgical intervention.
- Pre-operative diagnostic evaluations, including hemodynamic and angiocardiographic studies, are standard but may prolong the diagnostic process.
Purpose of the Study:
- To evaluate the efficacy of surgical treatment for congenital heart disease in a large cohort without routine pre-operative hemodynamic assessment.
- To determine the correlation between pre-operative echocardiography and surgical findings in pediatric CHD cases.
Main Methods:
- Retrospective analysis of 141 consecutive pediatric congenital heart disease surgical cases.
- Review of pre-operative echocardiographic (eco-2D) data and correlation with intra-operative anatomical and surgical findings.
- Patient age ranged from 1 day to 15 years, encompassing various CHD types.
Main Results:
- Adequate correlation was observed between 2D echocardiography and anatomical-surgical findings across diverse congenital heart defects.
- Surgical intervention was successfully performed in 141 cases, with a wide spectrum of diagnoses including ductus arteriosus, atrial septal defect, and Tetralogy of Fallot.
Conclusions:
- A significant percentage of congenital heart disease cases can be considered for surgical treatment without the mandatory need for invasive hemodynamic and angiocardiographic studies.
- Pre-operative echocardiography provides sufficient information for surgical planning in many pediatric CHD cases, potentially simplifying the pre-surgical workup.
Abstract:
Our initial experience with surgical treatment of congenital heart disease in 141 consecutive cases without the need of hemodynamic study is described. Ages ranged between 1 day and 15 years; 39 cases under 1 months of age (23 in the first week of life), 38 between 1 and 12 months, and 64 above 1 year of age. Diagnosis were: ductus 32 cases, atrial septal defect 24, Fallot's tetralogy 14, aortic coarctation 13, complete AV canal defect 7, D-transposition of the great arteries 5, ventricular septal defect 6, pulmonary atresia with intact ventricular septum 5, aortic stenosis 3, tricuspid atresia 4, pseudotruncus 2, univentricular heart 2, atrial myxomas, 2, Fallot's like 3, other type of congenital heart defect 19 cases. There was an adequate correlation between eco-2D images and anatomic-surgical findings. In conclusion, we think that a great percentage of cases affected of congenital heart disease should be considered for surgery without the need of a hemodynamic and angiocardiographic study.