title: [Strategy for surgery in neonates with coexisting congenital heart diseases].
abstract: To determine the most appropriate treatment strategy for neonates with coexisting congenital heart diseases (CHD) requiring surgery, 408 neonates treated in our department between 2002 and 2009 were retrospectively reviewed. Of the 408 neonates, 37 (9.1%) had coexisting CHD. Among the pediatric diseases requiring surgery, esophageal atresia (46.7%), anorectal malformation (24.1%), and tracheobronchial anomalies (75.0%) were frequently associated with CHD, and the survival rate among patients with coexisting CDH was 24.3%, about 2-fold higher than among those without coexisting CHD. Clinical observations in the present series suggested that fatal conditions such as tracheoesophageal fistula should be repaired immediately after birth, followed by palliative cardiac surgery to stabilize the circulatory status if necessary. Thereafter, radical repair of cardiac and pediatric anomalies should be performed, taking into account the balance between surgical stress and cardiac reserve. For this purpose, proper assessment of surgical stress and cardiac function and collaboration among specialists in relevant fields are essential during the perinatal period to determine the treatment strategy for patients with multiple-organ anomalies.
authors.affiliation: Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kuroda
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kitano
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Akihiro
authors.initials: A
authors.lastname: Fujino
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Watanabe
authors.forename: Noriko
authors.initials: N
authors.lastname: Takeda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsuda
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yamane
authors.forename: Masaya
authors.initials: M
authors.lastname: Suzuhigashi
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Hirata
authors.forename: Ikuya
authors.initials: I
authors.lastname: Achiwa
mesh_terms: D000015:Abnormalities, Multiple / Q000601:surgery*; D000071056:Anorectal Malformations; D001006:Anus, Imperforate / Q000601:surgery; D001980:Bronchi / Q000002:abnormalities; D004933:Esophageal Atresia / Q000601:surgery; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D010347:Patient Care Planning; D012189:Retrospective Studies; D014132:Trachea / Q000002:abnormalities