[Improving surgical results for cardiovascular anomalies in neonates]

The surgical results for congenital cardiovascular anomalies in neonates between August 1987 and July 1997 were reviewed. Two hundred thirty-four neonates underwent the corrective surgery with the use of cardiopulmonary bypass (CPB) for the cardiac anomalies including transposition of the great arteries (d-TGA) (157 patients), total anomalous pulmonary venous connection (TAPVC) (44 patients), cardiac defects with the aortic arch anomalies (11 patients), and others (22 patients), with an early mortality rate of 12%. The survival rates through the arterial switch operation for d-TGA and correction for TAPVC in 30 days were satisfactory (92% and 89%, respectively). The early mortality rate of palliative surgery done without CPB in 115 neonates due to aortic arch anomalies, pulmonary outflow tract obstruction, or pulmonary hypertension was low (6%). In contrast with these results, the outcome of palliative surgery using CPB for hypoplastic left heart syndrome, the aortic arch anomalies with subaortic stenosis, or TAPVC in asplenia hearts was poor, with the surgical mortality of 80%.