Mitsuru Muto1, Koshiro Sugita2, Tomoyuki Matsuba3, Chihiro Kedoin2, Mayu Matsui2, Shinichiro Ikoma4, Masakazu Murakami2, Keisuke Yano2, Shun Onishi2, Toshio Harumatsu2, Koji Yamada2, Waka Yamada2, Makoto Matsukubo2, Takafumi Kawano4, Seiro Machigashira4, Motofumi Torikai4, Tatsuru Kaji5, Satoshi Ibara6, Yutaka Imoto3, Yoshiharu Soga3, Satoshi Ieiri2. 1. Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890 -8520, Japan. mitsuru@m3.kufm.kagoshima-u.ac.jp. 2. Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890 -8520, Japan. 3. Department of Cardiovascular Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. 4. Department of Pediatric Surgery, Kagoshima City Hospital, Kagoshima, Japan. 5. Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan. 6. Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
Abstract
PURPOSE: Representative neonatal surgical diseases are often complicated by congenital heart disease (CHD). We reviewed our decade of experience from the perspective of the prognosis and report on the management of infants with CHD. METHODS: Cases with and without CHD between 2011 and 2020 were retrospectively compared. Qualitative data were analyzed using a chi-square test with Yates' correction, and quantitative data were compared using Student's t-test. RESULTS: Of the 275 neonatal surgical cases, 36 had CHD (13.1%). Ventricular septal defect was the most common cardiac anomaly, followed by atrial septal defect. Esophageal atresia showed the highest complication rate of CHD (43.8%, 14/32) followed by duodenal atresia (38.5%, 10/26). The mortality rates of patients with and without CHD (22.2% [8/36] vs. 1.3% [3/239]) were significantly different (χ2 = 30.6, p < 0.0001). Of the eight deaths with CHD, six patients had cyanotic complex CHD. Notably, four of these patients died from progression of inappropriate hemodynamics in the remote period after definitive non-cardiac surgery. CONCLUSION: Considering its high-mortality, the presence of CHD, especially cyanotic heart disease, is an important issue to consider in the treatment of neonatal surgical diseases. Pediatric surgeons should be alert for changes in hemodynamics after surgery, as these may affect mortality.
PURPOSE: Representative neonatal surgical diseases are often complicated by congenital heart disease (CHD). We reviewed our decade of experience from the perspective of the prognosis and report on the management of infants with CHD. METHODS: Cases with and without CHD between 2011 and 2020 were retrospectively compared. Qualitative data were analyzed using a chi-square test with Yates' correction, and quantitative data were compared using Student's t-test. RESULTS: Of the 275 neonatal surgical cases, 36 had CHD (13.1%). Ventricular septal defect was the most common cardiac anomaly, followed by atrial septal defect. Esophageal atresia showed the highest complication rate of CHD (43.8%, 14/32) followed by duodenal atresia (38.5%, 10/26). The mortality rates of patients with and without CHD (22.2% [8/36] vs. 1.3% [3/239]) were significantly different (χ2 = 30.6, p < 0.0001). Of the eight deaths with CHD, six patients had cyanotic complex CHD. Notably, four of these patients died from progression of inappropriate hemodynamics in the remote period after definitive non-cardiac surgery. CONCLUSION: Considering its high-mortality, the presence of CHD, especially cyanotic heart disease, is an important issue to consider in the treatment of neonatal surgical diseases. Pediatric surgeons should be alert for changes in hemodynamics after surgery, as these may affect mortality.
Authors: Michał Wojtalik; Wojciech Mrówczyński; Jacek Henschke; Krzysztof Wronecki; Aldona Siwińska; Maciej Piaszczyński; Malgorzata Pawelec-Wojtalik; Bartłomiej Mroziński; Małgorzata Bruska; Michał Błaszczyński; Rafł Surmacz Journal: J Pediatr Surg Date: 2005-11 Impact factor: 2.545
Authors: David Faraoni; David Zurakowski; Daniel Vo; Susan M Goobie; Koichi Yuki; Morgan L Brown; James A DiNardo Journal: J Am Coll Cardiol Date: 2016-02-23 Impact factor: 24.094