Early cardiopulmonary bypass surgery in critical low birth weight and premature infants with congenital heart defect / 中华急诊医学杂志

ABSTRACT

Objective To evaluate early and mid-term results in infants,weighing less than 2 500 g,who underwent early cardiac surgery on cardiopulmonary bypass (CPB).Method Since November 2003 to December 2007,28 consecutive infants of less than 2 500 g underwent early cardiac surgery on CPB in Children's Hospital Affiliated to Fudan University.Sixteen infants were male,and 12 infants were female.The mean pregnancy period was 34 weeks (30 to 41 weeks) ,and 14 patients were premature,and the mean birth weight was 2 010 g(1 370-2 500 g).Mean age at operation was 27.46 d (range 1～61 d),and mean weight was 2 391 g (range 1 500～2 500 g).Deep hypothermia circulatory arrest was used in 9.Indications for surgery wereventricular septal defect (10 infants),transposition of great arteries (6 iofants),totally anomalous pulmonary venom return (5 infants),pulmonary atresia with intact ventricular septum(2 infants),coarctation of aorta (1 infants) ,interrupted aortic arch (1 infants),cortriatriatum(1 infants),abnormal original of fight pulmonary artery (1 infants).Resuits Two (7.14%) infants died after operation at early phase.Mean duration of mechanical ventilation and intensive care unit stay were 113.9 h and 14.4 d,respectively.During follow-up (mean 16.87 months),one died.Two patients needed reintervention.About 84.4% infants didn' t need reintervention at the end of 12-month followup.Conclusions If medicine is aseless,infants woth low birth weight and congenital heart defect can obtain satisfactory outcome after CPB.Perioperative proration for virtual organs should be payed attention to.