Abstract
In this issue of the Journal, Kalfa and associates 1 from Columbia University describe their experience with surgical repair of congenital heart disease in patients weighing less than 2.5 kg. This study shows excellent results in the small patient population with an overall mortality of 10.9%, a mortality rate that is lower than in most reported series. The group of patients weighing less than 2.5 kg at surgical intervention was compared with a group weighing 2.5 to 4.5 kg at the same institution to determine the potential role played by prematurity, STAT risk category, univentricular or biventricular pathway, and timing of surgery over a 6year period from 2006 to 2012. Hospital mortality was significantly higher in the low birth weight group at 10.9% versus 4.8% in a group of infants weighing 2.5 to 4.5 kg. Postoperative length of stay, unplanned reintervention rates, and late mortality were not different between the 2 groups; however, follow-up was short. Early outcomes were not dependent on STAT risk categories, univentricular or biventricular pathway, or timing of surgery, although these factors were associated with outcomes in the higher weight group. Lower gestational age at birth was an independent risk factor for early mortality in the small birth weight group. Kalfa and associates 1 suggest that the use of a dedicated neonatalintensivecare unitfor themanagement oflowbirth weight patientsmay have an effect on outcome and partially explain the excellent results in this series along with a dedicated and highly experienced surgical team. Many studies have shown that the risk of surgical intervention for low birth weight neonates is significantly higher among essentially all risk categories than in higher birth weight infants. 2-5 This has been supported by analysis of
Published Version
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