Outcomes following surgery for congenital heart disease in low-birthweight infants.
OBJECTIVE
To describe cardiac surgery, survival and outcomes for low-birthweight (< or = 2500 g) infants undergoing surgery for congenital heart disease.


METHODS
Using data from a prospectively collected population-based database of admissions to neonatal intensive care units in New South Wales and the Australian Capital Territory, we identified all low-birthweight infants undergoing cardiac surgery between 1992 and 2001. Infants with only a persistent ductus arteriosus were excluded. Two-year cardiac and neurodevelopmental outcome data were sought from hospital medical records.


RESULTS
A total of 121 low-birthweight infants underwent cardiac surgery, of whom 34% had a congenital syndrome or non-cardiac birth defect. Most (81%) underwent a palliative surgical procedure in the neonatal period. There were 19 early (15.7%) and 19 late deaths giving a 2-year mortality of 31%. Factors associated with mortality included birthweight below 1500 g (P = 0.006), low weight at surgery (P = 0.028) and Apgar score at 1 min (P = 0.019). No single factor predicted 30-day mortality. By 2 years of age, 27 (33% of survivors) were known to have neurodevelopmental delay. Although 22 children are known to be developing normally, the neurodevelopmental status of 34 children was not known.


CONCLUSIONS
These surgical data were comparable to previous single-institution studies. This group had a high risk of disability due to prematurity, low birthweight and associated conditions. There is a need to prospectively assess and manage neurodevelopmental outcomes in this group.
Dimmick
Simon
S
The Children's Hospital at Westmead, New South Wales, Australia.
Walker
Karen
K
Badawi
Nadia
N
Halliday
Robert
R
Cooper
Stephen G
SG
Nicholson
Ian A
IA
Sherwood
Megan
M
Chard
Richard B
RB
Hawker
Richard
R
Lau
Kai C
KC
Jones
Owen
O
Grant
Peter W
PW
Sholler
Gary F
GF
Winlaw
David S
DS
D020958:Australian Capital Territory; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D009517:New South Wales; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies