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PO-0024 Clinical Course Features Of Newborns With Congenital Heart Defects: 15 Years’ Experience Of Our Centre
  1. O Filaretova1,
  2. M Tumanyan2,
  3. V Chechneva2,
  4. A Anderson2,
  5. E Levchenko2,
  6. A Kotova2,
  7. JU Butrim2,
  8. A Kim3,
  9. L Bokeria4
  1. 1Pediatric Cardiology Course at the Chair of Cardiovascular Surgery and Interventional Cardiology, Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia
  2. 2Department of Intensive Cardiology for Newborns and Infants with Congenital Heart Disease, Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia
  3. 3Department of Reconstructive Surgery of Newborns and Infants, Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia
  4. 4The Head and Chairman, Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia

Abstract

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).

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