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"Stone heart" in a neonate

J C Opie, G Taylor, P G Ashmore

    The Journal of Thoracic and Cardiovascular Surgery
    |March 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

    A neonate with congenital heart disease developed a rare complication, "stone heart," during surgery. Deep hypothermia did not prevent this fatal myocardial event, highlighting a new risk in neonatal cardiac repair.

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    Area of Science:

    • Pediatric Cardiology
    • Cardiovascular Surgery
    • Neonatal Medicine

    Background:

    • A neonate presented with a complex congenital heart defect including interrupted aortic arch, ventricular septal defect, atrial septal defect, and patent ductus arteriosus.
    • Additional congenital anomalies were noted, including bilateral cleft lip and palate, low-set ears, and bilateral colobomas.

    Observation:

    • A one-stage total correction of the interrupted aortic arch complex was performed using standard hypothermic techniques.
    • The surgical repair involved a 65-minute period of circulatory arrest at 18°C.
    • During rewarming, at 27°C, the neonate developed myocardial tetanic contracture, a condition known as "stone heart."

    Findings:

    • Cardiac action did not resume despite resuscitation efforts, and the infant expired on the operating table.

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  • Histological examination of the heart revealed extensive calcium flooding and myofibrillar degeneration (contraction bands).
  • This represents the first reported case of "stone heart" complication in a neonate undergoing surgery for congenital heart disease.

    • Implications:

    • Deep hypothermia did not prevent the occurrence of ischemic myocardial contracture in this case.
    • This rare and fatal complication, "stone heart," must be recognized as a potential risk in neonatal cardiac surgery.
    • The findings underscore the need for further research into preventing myocardial injury during complex neonatal cardiac repairs.