The purpose of the study was to prove to efficacy of Milrinone in the management of open heart surgery in children with congenital heart malformations, the link between Milrinone efficacy and the prevention of low cardiac output syndrome and Milrinone side effects. We conducted a retrospective study on a group of 24 patients, admitted to the Tg Mures Emergency Institute for Cardiovascular Diseases and Transplant, between August 2016 and February 2017. Milrinone was administered to children that underwent open heart surgery for different congenital heart malformations, using doses between 0.25 and 0.75 mcg per kg bodyweight, in continuous intravenous drip, before de-clamping of the Aorta, the procedures being conducted in extracorporeal circulation. We recorded demographic data, biological parameters of renal function, myocardial function and hemodynamic parameters, before and after surgery. The administration of Milrinone determined a reduction of incidence of low cardiac output syndrome, registering only 4 deaths, the survival rate being 83.33%, 13 cases presenting complications. Postoperatively we registered a significant improvement of the mean heart rate. Milrinone proved efficient in the re-establishment of hemodynamic parameters in patients with this type of clinical manifestations. Using Milrinone in children that undergo open heart surgery determines a decrease in incidence of low cardiac output syndrome, its� presence in the pharma market being necessary.

Introduction. With an estimated incidence of 6 cases to 1000 births worldwide, congenital cardiac malformations (CHM) are one of the main causes of death during the first year of life. The main issues regarding CHM management in Romania are the lack of data that describe the true incidence on population level, lack of standardized diagnosis and CHM reporting at national level. In Romania we see only local attempts at establishing such a CHM registry. Objectives. Measuring and analyzing the incidence of CHM in children within the Pediatric Cardiovascular center of the Emergency Cardiovascular and Transplant Institute in Targu Mures (IUBCvT) in order to determine de rate of enrollment, contouring the registration and follow-up form for CHM. Material and methods. We have conducted a retrospective, descriptive study concerning children discharged between 2008-2013, with a main diagnosis or comorbidity belonging to the category Q20-Q28 (Congenital cardiac malformations – ICD 10 AM), belonging to the Pediatric Cardiovascular center of IUBCvT. The study group was made up of 839 new-born babies discharged from the Neonatology clinic of the Mures County Emergency Clinical Hospital (SCJU) and 2181 children discharged from IUBCvT. Results. The incidence of CHM in new-born babies discharged from SCJU varied between 5.23% and 11.47%. Of the total 839 new-born babies, 139 underwent surgery in the IUBCvT within the first 30 days of life. The most frequent malformations found were interatrial communication (46.52%), persistent ductus arteriosus (22.10%), interventricular communication (9.04%). Disease group based morbidity within the IUBCvT demonstrates the large share of interventricular communication (20.05%), interatrial communication (15.98%) respectively of persistent ductus arteriosus (13.05%). Of the 1255 children that underwent surgery, the most frequent procedures (17.93%) were conducted for interatrial communication. Conclusions. Establishing a CHM clinical registry is important for the screening, diagnosing, monitoring of congenital cardiac malformations as well as aiding in choosing the right treatment path.

Introducere. Cu o incidenţă estimată la nivel mondial de 6 în 1.000 de nou-născuţi, malformaţiile cardiace congenitale (MCC) sunt una dintre principalele cauze ale mortalităţii în primul an de viaţă. Principalele probleme în managementul malformaţiilor cardiace congenitale (MCC), în România, sunt lipsa de date care să descrie incidenţa reală la nivel populaţional, lipsa de standardizare în diagnosticul şi raportarea MCC la nivel naţional. În România, există doar încercări locale de a dezvolta un registru de malformaţii cardiace. Obiective. Măsurarea şi analiza incidenţei MCC la copii în Centrul Pediatric Cardiovascular al Institutului de Urgenţă pentru Boli Cardiovasculare şi Transplant Tg. Mureş (IUBCvT) în vederea determinării ratei de înrolare, stabilirea formularului de înregistrare şi urmărire al Registrului Clinic de Monitorizare al MCC. Material şi metodă. A fost realizat un studiu descriptiv retrospectiv al copiilor externaţi cu un diagnostic principal sau comorbiditate din categoria Q20-Q28 (Malformaţii cardiace congenitale – ICD 10 AM), în perioada 2008- 2013, la nivelul Centrului Pediatric Cardiovascular al Institutului de Urgenţă pentru Boli Cardiovasculare şi Transplant Târgu-Mureş. Lotul de studiu a cuprins un număr de 839 de nou-născuţi externaţi din secţia Neonatologie a Spitalului Clinic Judeţean de Urgenţă Târgu-Mureş (SCJU), respectiv 4.423 de copii externaţi din IUBCvT. Rezultate. Incidenţa MCC la nivelul nou-născuţilor externaţi din SCUJ a variat între 5,23% şi 11,47%. Din cei 839 nou-născuţi, 139 au fost operaţi în cadrul IUBCvT în primele 30 zile de viaţă. Cele mai frecvente malformaţii sunt Comunicaţie interauriculară (46,52%), Permeabilitatea canalului arterial (22,10%), Comunicaţia inter ventriculară (9,04%). Morbiditatea spitalizată pe grupe de boli la nivelul IUBCvT demonstrează ponderea ridicată a Comunicaţiei interventriculare (20,05%), a Comunicaţiei interauriculare (15,98%) şi a Permeabilităţii canalului arterial (13,05%). Din cei 1.255 de copii la care s-a intervenit chirurgical, cele mai frecvente intervenţii chirurgicale (17,93%) au fost pen tru Comunicaţie interauriculară. Concluzii. Întocmirea unui Registru al MCC este importantă pentru depistarea, diagnosticul, monitorizarea şi instituirea unei atitudini terapeutice adecvate.