Aim A retrospective cohort study was made as well as a comparative analysis of the medical and surgery results of newborns with congenital heart defects (CHD).
Materials 2440 newborns (median: 8 days [IQR:2–18 days], 3.25 kg [IQR:0,85–6,5 kg]) underwent surgical repair in the Bakoulev SCCVS between 1999 and 2013. At the time of corrective surgery 1104 (51%) patients were up to 7 days old with critical CHD (median:2,9 kg [IQR:0,85–5,1 kg]). Among them 526(48%) were 1 day old. All newborns were divided into two groups by the number of surgical repairs performed per year: group 1-up to 100 patients (1999–2004,n = 305), and group 2–more than 100 patients (2005–2013,n = 2135). The survival analysis was made according to Kaplan and Meier method (K-M).
Results The CHD range was primarily represented by aortic obstructive lesions (622–25,5%), transposition complexes (488–20%), tetralogy of Fallot complexes (193–7,9%), critical pulmonary stenosis/atresia with intact septum (183–7,5%) and others. 47% undergone complete repair of CHD. The following risk factors (n = 6) for increased post-operative mortality by multivariate analysis (p = 0.0001) were identified. Progressive deteriorate on of the surgical results survival increased with number of risk factors, regardless of their combination (ROC-curve: AUS=0.8073, K-M p = 0.00001). 22 diagnostic/treatment strategies of critical neonates with CHD were developed. Over a period of study the capacity of surgery care was expanded (p.001), including complete repair CHD (42% vs 49%,p = 0.01). Morbidity of critical neonates decreased in both preoperative (21% vs 0,01% p = 0.0002) and postoperative period (K-M p = 0.000001). Actuarial survival rate was improved both for neonates undergoing palliative surgery (p = 0.0003) and complete repair (p = 0.000001).