Initiation of a pediatric cardiac surgery program in 2020

Abstract

The goal of this study is to describe the preparation and the first year of experience of the pediatric cardiac surgery program at our institution, where such a program was not available before 2020. The project was initiated by the university hospital, in collaboration with the Regional Health Agency. Transborder staff training and significant investments were supported by the Interreg program. A multidisciplinary team was built, which started the pediatric ECMO program in the pediatric intensive care unit prior to the surgical program and set up a parallel program dedicated to the neurodevelopmental follow-up of operated infants. Importantly, a progressive upscale was devised: only children with a weight > 5 kg requiring low or moderate-complexity surgeries were operated on during the first year. From October 2020 to December 2021, 77 children were operated on, including 64 in the new pediatric cardiac surgery program. Repeated waves of COVID-19 made the start of the program difficult by restricting access to the operating room. The age of the 64 patients of the new program was 6.2 years old (1.7–9.5). Cardiopulmonary bypass cases represented 47 (74.6%) of all cases. In addition to low-complexity surgeries, procedures such as tetralogy of Fallot repair ( n = 6) and bilateral cavopulmonary connection ( n = 4) were performed. There were no early or late deaths postcardiotomy. Intensive care and hospital stays were 3 (2–7) and 6 (5–11) days, respectively. Our pediatric cardiac surgery program achieved very satisfactory outcomes in selected patients, despite difficulties related to the current pandemic. Institutional support, meticulous planning and excellent team cohesion were keys for successful initiation of our program.