Survival after surgery with cardiopulmonary bypass in low weight patients.
To evaluate risk factors for hospital death in patients weighing < 2.5 kg undergoing open-heart surgery, records of 34 consecutive low-weight patients operated on between December 1997 and November 2004 were reviewed. Mean weight was 2.152 +/- 0.237 kg (range, 1.600 to 2.460 kg). Biventricular repair was achieved in 28 patients. The most frequent procedures were the arterial switch operation in 9 children, ventricular septal defect closure in 6, repair of total anomalous pulmonary venous connection in 5 and truncus arteriosus repair in 5. There were 8 early deaths. Mortality was strongly associated with the Comprehensive Aristotle Complexity Score: mortality was low (2/27; 7.4%) with a score < 19, and high (6/7; 85.7%) with a score >/= 19. Higher mortality was encountered after univentricular repair (4/6; 67%). Hyperlactatemia at the end of cardiopulmonary bypass was also associated with poor survival. A Comprehensive Aristotle score < 19 was the strongest predictor of survival in low-weight patients undergoing open-heart surgery. Biventricular repair, when feasible, should be promoted to improve outcome.
Miyamoto
Takashi
T
Department of Cardiovascular Surgery, Gunma Children's Medical Center, 779, Shimohakoda, Hokkitsu, Shibukawa, Gunma, 377-8577, Japan. yonomiyataka@msn.com
Sinzobahamvya
Nicodème
N
Photiadis
Joachim
J
Brecher
Anne M
AM
Asfour
Boulos
B
D000140:Acidosis, Lactic / Q000209:etiology / Q000401:mortality; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D002315:Cardiopulmonary Bypass / Q000401:mortality*; D005260:Female; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000401:mortality* / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome