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Structural heart disease in the newborn. Changing profile: comparison of 1975 with 1965
Insights
Early detection and treatment of congenital heart disease in infants has improved outcomes. Survival rates for cyanosis and congestive heart failure increased, alongside a significant rise in post-surgery survival by 1975.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Neonatal Care
Background:
- Congenital structural heart disease (CSHD) diagnosis and management have evolved.
- Improved survival rates in neonates with cardiac conditions have been observed.
Purpose of the Study:
- To evaluate changes in the assessment and treatment of CSHD.
- To analyze trends in CSHD incidence and outcomes over a decade.
Main Methods:
- Retrospective analysis of CSHD cases treated between 1965 and 1975.
- Comparison of diagnostic and therapeutic approaches over the study period.
- Review of survival data for neonates with cyanosis, congestive heart failure, and post-surgery.
Main Results:
- Case numbers for CSHD increased from 121 in 1965 to 226 in 1975.
- Patient ductus arteriosus incidence rose due to increased survival of premature infants.
- First-month survival for cyanosis was 80% and for congestive heart failure was 60% by 1975.
- Post-surgery survival rate improved from 37% in 1965 to 70% in 1975.
Conclusions:
- Earlier detection and intervention have enhanced CSHD patient management.
- Advances in non-invasive investigations and surgical care have significantly improved neonatal cardiac survival rates.
- Increased survival of premature infants contributed to a rise in specific malformations like patient ductus arteriosus.
Abstract:
The earlier detection and investigation of babies with congenital structural heart disease has resulted in earlier treatment and better management of these patients. In 1965, at the Hospital for Sick Children, Toronto, 121 cases were assessed and treated; by 1975 this figure had risen to 226 cases. Few changes were noted in the incidence of the 10 most common malformations, except for the obvious increase in the incidence of patient ductus arteriosus due to survival of increasingly premature infants. The sick cardiac neonate was referred earlier in 1975, studied with newer non-invasive investigations, and, according to the severity of symptoms and signs, was sent sooner to cardiac catheterisation. 80% of babies presenting with cyanosis survived the first month and 60% of babies with congestive heart failure survived. With better surgery and perioperative care, the survival rate in the first month after surgery rose from 37% in 1965 to 70% in 1975.