Open-heart surgery in premature and low-birth-weight infants--a single-centre experience.
OBJECTIVE
Because of their poor clinical status, infants may require surgery for congenital heart disease regardless of weight or prematurity. This retrospective review describes a single-centre experience with open-heart surgery in low-weight infants.


METHODS
From November 1997 to December 2006, 411 open-heart surgery procedures were performed in neonates. This included 46 consecutive infants weighing less than 2500 g, who underwent cardiopulmonary bypass for correction of congenital heart defects (n=34) or Norwood stage I palliation of hypoplastic left heart syndrome (HLHS) (n=12). In the low-weight group were 23 males and 23 females with a median age of 10 days and a median weight of 2.26 kg (range: 1.28-2.49 kg).


RESULTS
Early mortality was 8.2% in patients weighing more than 2.5 kg and 13% in the low-weight group. Within the low-weight group, weight at surgery, history of prematurity and prevalence of additional extracardiac malformations did not influence early mortality. At a median follow-up time of 32 months overall mortality was 21%. Thirty-four patients had a neurological follow-up examination 30 months postoperatively. Of the 34 survivors, 11 showed neurological deficits.


CONCLUSIONS
In our patient population, early mortality was higher for infants weighing less than 2.5 kg. However, within the low-weight group, lower weight at surgery or history of prematurity was not associated with a higher mortality or bad neurological outcome.
Lechner
Evelyn
E
Department of Neonatology, Children's and Maternity Hospital Linz, Krankenhausstrasse 26-30, 4020 Linz, Austria. elechner@aon.at
Wiesinger-Eidenberger
Gabriele
G
Weissensteiner
Martin
M
Hofer
Anna
A
Tulzer
Gerald
G
Sames-Dolzer
Eva
E
Mair
Rudolf
R
D000367:Age Factors; D001724:Birth Weight; D002315:Cardiopulmonary Bypass; D002658:Developmental Disabilities / Q000209:etiology; D004812:Epidemiologic Methods; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000601:surgery; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000601:surgery*; D008297:Male; D010166:Palliative Care / Q000379:methods; D011379:Prognosis; D016896:Treatment Outcome