Emergency surgical treatment on critical infants with congenital heart diseases / 第三军医大学学报

ABSTRACT

Objective To evaluate the efficiency of emergency surgery to consecutive 258 infants suffering with critical congenital heart diseases (CHD). Methods From January 2006 and February 2009,emergency surgery was performed within 24 h after definite diagnosis on 258 children with critical congenital heart diseases,including 150 males (58.1%) and 108 females (41.9%),with a mean age of (7.5?4.3) months (ranging from 6 d to 11 months),at a mean weight of (5.5?3.3) kg (ranging from 2.1 to 9.5 kg). Complications such as refractory pneumonia,heart failure,repeated episodes of hypoxic spells,kidney dysfunction,liver dysfunction,severe anaemia or growth retardation were found in 233 infants (90.2%). Totally 246 (95.3%) of them were operated on CPB with heart arrested,and 12 (4.7%) with patent ductus arteriosus and operated off pump. Results This group of patients had a stage-one corrective rate of 92.3%,and a total curative rate of 96.9%. In infants operated with heart arrested and with heart beating,the duration of cardiopulmonary bypass was 105.00?38.71 min and (71.89?27.78) min respectively,postoperative ventilation duration was (16.5?9.3) h,intensive care unit (ICU) staying duration was (98.5?33.6) h. After operation,low cardiac output syndrome occourred with a rate of 6.9% and severe complications of major organs with a rate of 12.9%. Of 8 (3.1%) dead infants,7 were diagnosed with complicated CHD. Five died of low cardiac output syndrome,1 of arrhythmia,1 of respiratory failure and 1 of arrhythmic heart. Conclusion Emergency surgical treatment should be performed as soon as definite diagnosis for critical infants with congenital heart disease. Heart failure,respiratory failure,liver dysfunction,severe anaemia and infection are not contraindications to surgical treatment. However,complex anomalies and younger age are considered to be the most risk factors for surgery of infants with CHD.