ABSTRACT
OBJECTIVE: To report survival of newborns with congenital heart disease who underwent cardiac surgery during neonatal period. DESIGN: Descriptive, ambispective. SETTING: Neonatal Intensive Care Unit (NICU), Hospital de PediatrÝa, Centro MÚdico Nacional Siglo XXI. PATIENTS: We studied 74 newborns with congenital heart defects who underwent corrective surgery, palliative surgery or interventional techniques and received preoperative and postoperative care in NICU. Premature patients with patent ductus arteriosus were excluded. RESULTS: The following median values were found: birth weight was 2,862 g, gestational age was 39 weeks, onset of symptoms was 1 day, age at surgery was 14.5 days and postoperative hospital stay was 9 days. Most frequent congenital heart defects were single-ventricle, transposition of the great arteries and hypoplastic right heart. Fifty percent of surgeries were corrective, 46 were palliative and 4 were interventional techniques. Global survival was 51, for curative surgery was 43 and for palliative surgery was 58. Only 3 patients underwent interventional cardiology, 2 of them died (survival 33). CONCLUSIONS: Global survival in newborns who underwent cardiac surgery is lower in comparison with other studies. Survival is higher in children with palliative surgery in comparison with those who underwent corrective surgery.
Subject(s)
Humans , Male , Female , Infant, Newborn , Radiology, Interventional , Cardiac Surgical Procedures , Heart Defects, Congenital/mortality , Cardiac Catheterization , Birth Weight , Intensive Care Units, Neonatal , Radiology, Interventional , Prospective Studies , Retrospective Studies , Gestational Age , Treatment Outcome , Hospital Mortality , Cardiac Surgical Procedures , Mexico , Survival Analysis , Palliative Care , Heart Defects, Congenital/surgery , Cardiac Catheterization/statistics & numerical data , Postoperative Complications/mortality , Infections/mortality , Length of StayABSTRACT
La compresión traqueo-esofágica secundaria a anomalías vasculares es una situación poco común, que puede ser enmascarada por síntomas respiratorios inespecíficos. Se describen dos casos de insuficiencia respiratoria grave, meritoria de asistencia mecanica a la ventilación, en pacientes con sobredistensión torácica que mejoraban al desplazar la cánula endotraqueal cerca de la carina. Las radiografías de tórax con datos de gran atrapamiento de aire, el esofagograma con indentación esofágica, el estudio endoscópico demostró la compresión extrínseca esofágica y traqueal. La angiografía documentó doble arco aórtico (DAA) en el primer caso y subclabia derecha aberrante en el segundo. Se realizó sección vascular y liberación de estructuras traqueo-esofágicas, con evolución clínica favorable. La disminución de la sobredistención torácica al colocar la cánula endotraqueal, dio la clave para sospechar obstrucción extrínseca. Un alto grado de sospecha es necesario para que el diagnóstico sea oportuno