[Cardiac surgical repair in newborns: five years' experience in neonatal open surgery].
BACKGROUND
Four hundred newborns die every year in our country suffering from congenital heart disease. Definitive surgical repair, whenever possible, is nowadays the optimal therapeutic strategy. Our goal is to describe mortality and morbidity in neonatal surgery with cardiopulmonary bypass in a tertiary public hospital in Argentina.


METHODS
Descriptive, retrospective study. Every patient, younger than 45 days, with cardiac surgery requiring cardiopulmonary bypass, at the Garrahan Hospital between 2004 and 2008 was included. Demographic, surgical and postoperative data were collected. Adjusted mortality risk analysis, and descriptive statistics from the most frequent diagnosis were performed. Results are expressed as median and rank or percentage.


RESULTS
200 newborns were operated, 62% males. Median age was 21 days (r 1- 45) and median weight 3.1 kg (r 1.6-6.2). Total anomalous pulmonary venous return, transposition of great arteries an hypoplastic left heart syndrome diagnoses accounted for 75% of the procedures. Median length of stay was 12 days (r 0-191), and 6 days of mechanical ventilation (r 0-180). Eighteen percent of the patients required peritoneal dialysis. Whole series mortality was 19% and fell to 14% in 2008. Unstable preoperative condition and postoperative complications increased mortality, OR= 2.23 (1.02-4.89) and OR= 10 (3.6-33.4), respectively.


CONCLUSIONS
Our postoperative mortality is similar to those reported in foreign countries databases. Patients with unstable preoperative condition and post-operative complications had higher mortality.
Magliola
Ricardo
R
UCI 35. Recuperación Cardiovascular, Hospital Nacional de Pediatría Prof. Dr. Juan P. Garrahan.
Althabe
María
M
Moreno
Guillermo
G
Lenz
Ana M
AM
Pilan
María L
ML
Landry
Luis
L
Balestrini
María
M
Charroqui
Alberto
A
Vassallo
Juan C
JC
Salgado
Gladys
G
Martín
Analía
A
Barretta
Jorge
J
Cornelis
Javier
J
García Delucis
Pablo
P
Suárez
José
J
Laura
Juan P
JP
D006348:Cardiac Surgical Procedures; D005260:Female; D006331:Heart Diseases / Q000151:congenital* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors