¿Cómo es la cirugía cardiaca neonatal en un centro terciario en México?

Abstract

Introduction and objectivesMexico has public and private institutions to provide healthcare to 120 million of habitants. Our pediatrics hospital is a public institution of the Mexican Social Security Institute. We report our experience in the surgical treatment of congenital heart disease during the neonatal period. MethodsFrom our service database, we included patients <30 days of life with congenital heart disease, receiving heart surgery during the period from September 2015 to September 2020. ResultsA total of 350 cases were included (171 male and 179 female), 111 were preterm babies (31.7%). Surgical closure of the persistent arterious duct was the most common procedure in 138 cases (39.4%), followed by modified Blalock-Taussig systemic pulmonary shunt in 92 cases (26.3%). Closed cardiac surgery (without extracorporeal circulation support) accounted for 68.6% of our surgeries. Other surgical techniques performed were arterial switch operation (N=38), anomalous pulmonary veins connection repair (N=37), truncus correction, coarctectomy, and Norwood palliation. Score surgical risk RACHS-1 were: I with 139 cases (39.7%), and ≥ III with 211 cases (60%). Inhospital mortality was 20% with 70 deaths, mainly related to cardiogenic shock (92%). Mean postoperative hospital stay in neonatal intensive care area was 20±11 days. ConclusionsOur department of pediatric heart surgery has experience in the treatment of neonates with congenital heart disease. Our data analysis let us to identify some areas of improvement in this complex neonatal management.