Cardiovascular surgery in very low birth weight (≤1500 g) neonates

Authors

Soichiro Henmi, Department of Pediatric Cardiac Surgery, Heart Institute, Children's National Hospital, George Washington University, Washington, DC, USA.
Yasin Essa, Department of Pediatric Cardiac Surgery, Heart Institute, Children's National Hospital, George Washington University, Washington, DC, USA.
Mahmut Öztürk, Department of Pediatric Cardiac Surgery, Heart Institute, Children's National Hospital, George Washington University, Washington, DC, USA.
Aybala Tongut, Department of Pediatric Cardiac Surgery, Heart Institute, Children's National Hospital, George Washington University, Washington, DC, USA.
Manan Desai, Department of Pediatric Cardiac Surgery, Heart Institute, Children's National Hospital, George Washington University, Washington, DC, USA.
Can Yerebakan, Department of Pediatric Cardiac Surgery, Heart Institute, Children's National Hospital, George Washington University, Washington, DC, USA.
Yves d'Udekem, Department of Pediatric Cardiac Surgery, Heart Institute, Children's National Hospital, George Washington University, Washington, DC, USA.

Document Type

Journal Article

Publication Date

12-2-2022

Journal

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

Volume

63

Issue

1

DOI

10.1093/ejcts/ezac552

Keywords

Cardiovascular surgery; Prematurity; Single ventricle; Very low birth weight

Abstract

OBJECTIVES: Low birth weight and prematurity are known risks of increased morbidity and mortality with undergoing cardiovascular surgery. Our aim was to review the outcomes of very low birth weight (≤1500 g) patients who have undergone cardiovascular surgery. METHODS: A retrospective review was performed for 32 very low birth weight (≤1500 g) patients who underwent cardiovascular surgery from 2004 to 2021 in our institution. RESULTS: Fifteen patients weighting ≤1500 g at surgery (≤1500-g group) were compared to 17 patients born with a weigh of ≤1500 g and weighting between 1500 and 2500 g at surgery (>1500- to ≤2500-g group) in this study. In-hospital mortality was 33% (5/15) in the ≤1500-g group and 24% (4/17) in the >1500- to ≤2500-g group (P = 0.55). All patients with simple biventricular lesion survived following full repair. The occurrence of postoperative intracerebral haemorrhage was significantly higher in those operated at weight ≤1500 g than those weighting >1500 to ≤2500 g (40% vs 0%; P = 0.01). The 1- and 3-year survival rates were 66.0 ± 12.4% and 46.2 ± 14.8% in the ≤1500-g group and 76.5 ± 10.3% and 70.6 ± 11.1% in the >1500- to ≤2500-g group (log-rank P = 0.12). CONCLUSIONS: Cardiac surgery for a very low birth weight neonate resulted in a high early and late mortality. Early surgery is only acceptable for simple biventricular lesions if needed. Delayed surgery seems to provide better long-term outcomes in patients with complex lesions. Alternative strategies for neonatal cardiopulmonary bypass should be investigated in patients with complex biventricular and single ventricular lesions.

APA Citation

Henmi, Soichiro; Essa, Yasin; Öztürk, Mahmut; Tongut, Aybala; Desai, Manan; Yerebakan, Can; and d'Udekem, Yves, "Cardiovascular surgery in very low birth weight (≤1500 g) neonates" (2022). GW Authored Works. Paper 2144.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2144

Department

Surgery