Open-heart surgery in preterm infants: A single-center experience

Area of Science:

• Pediatric Cardiac Surgery
• Neonatal Intensive Care
• Global Health Equity in Healthcare

Background:

• Open-heart surgery in preterm neonates presents significant challenges.
• Feasibility in low-resource settings remains undefined.
• This study details institutional experience with open-heart surgeries in preterm infants.

Purpose of the Study:

• To define the feasibility and outcomes of open-heart surgery in preterm neonates in a low-resource setting.
• To describe the characteristics and surgical management of preterm infants undergoing open-heart procedures.
• To evaluate the safety and efficacy of corrective cardiac operations in this vulnerable population.

Main Methods:

• Single-center retrospective cohort study of consecutive preterm neonates (<37 weeks) undergoing open-heart surgery.
• Included infants <3 months at surgery, analyzing gestational age, weight, and congenital heart defects.
• Detailed cardiopulmonary bypass times, cross-clamp times, and postoperative care metrics.

Main Results:

• Fifteen preterm infants (median gestational age 35 weeks, 80% small for gestational age) underwent surgery.
• Common defects included transposition of great arteries and total anomalous pulmonary venous return.
• No in-hospital mortality; one late mortality at 1 month. Postoperative sepsis occurred in 13.3%.

Conclusions:

• Collaborative, multidisciplinary management enables excellent outcomes for selected preterm neonates.
• Open-heart surgery is feasible and successful in low-resource environments for this population.
• Highlights the potential for advanced cardiac care in underserved regions.