Early intervention of neonates with critical congenital heart diseases

Abstract

Objective Reviewing the surgical outcome of neonates with critical congenital heart diseases(CHD) in the past five years, to summarize the experiences of the treatment for neonates with critical CHD. Methods From Jan.2009 to Dec.2013, 521 neonates with critical CHD were admited, all of them were received surgical treatment. Age ranged from 1day to 28 days, mean(21±6) days; weights ranged from 2.1 kg to 3.6 kg, mean(2.8±0.5)kg. All the children were received operation, and cared in cardiac intensive care unit(CCU) postoperatively. Results 22 cases died after surgery, the hospital mortality was 4.2%. 68 children were left sternal open after the primary repair; 39 children inhaled nitric oxide(NO) for the postoperative pulmonary hypertension; 22 children needed peritoneal dialysis for acute renal failure; 3 children used extracorporeal membrane oxygenation(ECMO) as circulatory support.Follow-up found 18 cases(12.1%) of TGA occurred supravalvular pulmonary stenosis after the arterial switch operation; 12 cases(11.0%) of CoA/VSDI 7 cases(5.6%) of TAPVD occurred postoperative pulmonary venous obstruction. Conclusion Early intervention of neonates with critical CHD has achieved excellent results. The time of operation, surgical techniques, cardiopulmonary bypass techniques and perioperative management are key factors to improve the outcome of critical CHD. Key words: Neonates; Congenital heart disease; Critical; Early intervention