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Cardiac Surgery with Cardiopulmonary Bypass in Low-Weight or Preterm Neonates:A Retrospective Study Analyzing Early Outcome

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Congenital Heart Disease 2023年第2期18卷 151-168页

作者： Alain J.Poncelet maureen peers de nieuwburgh Stéphane Moniotte Geoffroy de Beco Karlien Carbonez Jean E.Rubay Thierry detaille Laurent Houtekie Mona Momeni department of Cardiovascular and Thoracic Surgery Universitécatholique de LouvainCliniques Universitaires Saint-LucBrusselsBelgium department of Pediatric Cardiology Universitécatholique de LouvainCliniques Universitaires Saint-LucBrusselsBelgium department of Pediatric Intensive Care Universitécatholique de LouvainCliniques Universitaires Saint-LucBrusselsBelgium department of Anesthesiology Universitécatholique de LouvainCliniques Universitaires Saint-LucBrusselsBelgium

Background:Most outcome studies in congenital cardiac surgery for“low weight”neonates include patients undergoing surgery without cardiopulmonary bypass(CPB).The primary objective of our study was to identify risk factors for in-hospital mortality in neonates weighing less than 3 Kg and undergoing surgery with *** addition,we compared the effect of early surgery with CPB(before 37W-gestational age(GA))for congenital heart disease to delayed surgery until a corrected GA of 37 weeks in an attempt to promote weight ***:Retrospective single-center study including all patients operated between 1997 and ***-and multivariable analysis were used to analyze ***:143 patients were *** median weight was 2.7 Kg and 49(34.3%)weighteddelay(usual timing,median age 9 days),whereas 29 patients(20%)entered a delayed strategy(median age 30 days).In-hospital mortality was 21.7%.By multivariate analysis,dysmaturity,preoperative positive ventilation,post-operative ECMO requirement or resuscitation,and any residual lesion were predictors of in-hospital ***-hospital mortality in the usual timing group and the delayed group were 21.1%and 24.1%,respectively(p=0.71).In-hospital mortality for neonates operated prior to 37W-GA(n=10)was 27.3%.Conclusions:Predictors of in-hospital mortality in neonates less 3 Kg requiring CPB surgery did not differ from those unveiled in other contemporary *** data demonstrates that a strategy of delaying surgery in selected patients resulted in similar clinical outcome.

关键词： Congenital heart disease neonate perioperative care morbidity and survival

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