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[Our experience in heart surgery in early childhood (children less than 2 years old)]
Insights
This study analyzed 109 pediatric congenital heart disease surgeries from 1978-1981. Outcomes showed a 14% global mortality rate, with higher risks in infants under six months, highlighting the need for careful surgical consideration.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Disease
- Cardiovascular Surgery
Context:
- Surgical treatment of congenital heart disease in infants and young children presents significant challenges.
- Early surgical interventions are crucial for improving outcomes in pediatric patients.
- This review examines surgical outcomes for 109 patients under two years of age treated between 1978 and 1981.
Purpose:
- To evaluate the morbidity, mortality, and pulmonary management outcomes of surgically treated congenital heart disease in young children.
- To compare outcomes between different surgical techniques, including cardiopulmonary bypass and deep hypothermia with circulatory arrest.
- To analyze the impact of patient age and specific congenital heart defect types on surgical results.
Summary:
- The study reviewed 109 patients (under two years) undergoing surgery for congenital heart disease. 56 patients had cardiopulmonary bypass, and 41 used deep hypothermia with circulatory arrest. Postoperative pulmonary management showed similar outcomes across different defect types.
- Mortality was 19% (11 deaths) in the cardiopulmonary bypass group, primarily in infants under six months. In 53 patients operated without extracorporeal circulation, mortality was 9%, with all deaths in neonates.
- The global mortality rate was 14%, with all fatalities occurring in patients under six months of age.
Impact:
- Findings underscore the critical impact of age on surgical outcomes for congenital heart disease, particularly for neonates and infants.
- The study provides valuable historical data on surgical techniques and outcomes, informing current strategies for pediatric cardiac surgery.
- Results emphasize the importance of meticulous pulmonary management and highlight areas for potential improvement in surgical indications and patient selection.
Abstract:
We review 109 patients with congenital heart disease under (two year of life, surgically treated between June 1978 and October 1981; 44% were under six months and 71% were under one year. Fifty six patients were operated under cardio-pulmonary by-pass, in 41 we used deep hypothermia with total cardio-respiratory arrest, 21% of them were under three months of life an 53% under one year. We present the morbidity and mortality together with the pulmonary management. Eighty five percent of the cases remained intubated postoperative by for less than 12 hours. The postoperative pulmonary evolution was quite similar for different types of congenital heart disease, such as T. Fallot, A-V canal, transposition, etc., and there was no statistically significant difference between them in terms of respiratory assistance and pulmonary complications. Eleven patients died (19%), all of them under six months of life. In 53 patients operated, without extracorporeal circulation, 38 had total correction and 15 palliative procedures. The mortality in this group was 9% (5 cases), all of the under one month of life. The global mortality was 14%. We discuss our present surgical indications in view of our results.