Curi-Curi PJ, Cervantes-Salazar J, Calderón-Colmenero J, García-Montes JA, Ramírez S

Language: Spanish
References: 9
Page: 199-206
PDF size: 188.44 Kb.

ABSTRACT

Objective. To present our institutional postoperative results in cardiovascular surgery of the neonate, and to give an idea of its contribution to the national problematic knowledge in this area. Material and methods. A retrospective, descriptive, and observational study was carried out, including all neonates with congenital heart disease who were operated at the Ignacio Chávez National Cardiology Institute in a 7 year period. We made special emphasis in postoperative morbidity and mortality, as well as in the risk factors for early mortality. Results. We operated on 484 neonates with congenital heart disease due to total anomalous pulmonary venous conection, classic transposition of great arteries, pulmonary atresia, and aortic coarctation. Causes for early mortality were cardiac failure, pulmonary hypertension, pulmonary sepsis, and arrhythmias. Operative mortality was 12.2% and was due mainly to congenital heart disease with 5 and 6 RACHS-1 risk score. Risk factors for operative mortality were: age ‹ 15 days, body surface area ‹ 0.20 m², weight ‹ 4 kg, and univentricular heart physiology. Conclusions. There is still a high operative mortality for complex neonatal heart disease in this series. Our institutional outcomes can not be extrapolated to the rest of the country, but highlights several challenges that national pediatric health care institutions and associations must assume in order to improve the attention that neonatal patients demand.

REFERENCES

1. Jacobs JP, Maruszewski B, Kurosawa H, Jacobs ML, Mavroudis C, Lacour-Gayet FG, et al. Congenital heart surgery databases around the world: do we need a global database? Semin Thorac Cardiovasc Surg Pediatr Card Surg Ann 2010; 13: 3-19.

2. Kansy A, Tabota Z, Maruszewski B. Analysis of 14,843 neonatal congenital heart surgery procedures in the European Association for Cardiothoracic Surgery Congenital Database. Ann Thorac Surg 2010; 89: 1255-9.

3. Calderón-Colmenero J, Cervantes-Salazar JL, Curi-Curi P, Ramírez S. Problemática de las cardiopatías congénitas en México. Propuesta de regionalización. Arch Cardiol Mex 2010; 80(2): 133-40.

4. Calderón-Colmenero J, De la Llata M, Vizcaíno A, Ramírez S, Bolio A. Atención médico-quirúrgica de las cardiopatías congénitas: una visión panorámica de la realidad en México. Encuesta 2009. Rev Invest Clin 2011; 63(4): 344-52.

5. Disponible en: http://www.inegi.org.mx

6. Jenkins KJ, Gauvreau K, Newburger JW, Spray TL, Moller JH, Lezzoni L. Consensus-based method for risk adjustment for surgery for congenital heart disease. J Thorac Cardiovasc Surg 2002; 123: 110-8.

7. Castañeda AR, Jonas RA, Mayer JE, Hanley FL. Cardiac surgery of the neonate and infant. Philadelphia: W.B. Saunders Company; 1994.

8. Abrishamchian R, Kanhai D, Zwets E, Nie L, Cardarelli M. Low birth weight or diagnosis, which is a higher risk? A metaanalysis of observational studies. Eur J Cardiothorac Surg 2006; 30: 700-5.

9. Jonas R. Advances in cardiopulmonary bypass and extracorporeal membrane oxygenation for the neonate and infant. World Jour for Pediatric & Cong Heart Surg 2010; 1(2): 217-25.