Morbidity and mortality after surgery for congenital cardiac disease in the infant born with low weight

Ades, Anne; Dominguez, Troy E.; Nicolson, Susan C.; Gaynor, J. William; Spray, Thomas L.; Wernovsky, Gil; Tabbutt, Sarah

doi:10.1017/s1047951109991909

Cited by 76 publications

(83 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As reported by Ades et al, 24 postoperative extracorporeal circulation support was associated with mortality in the present study. Ten patients in the present study needed ECMO support after cardiac surgery, and only 1 patient survived.…”

Section: Discussionsupporting

confidence: 83%

“…We believed poor heart function after operation was the major cause of mortality. 25- 27 Ades et al reported 83% mortality in infants with low birth weight who had postoperative ECMO support, 24 and Seo et al reported 100% mortality. 4 In the present study, prolonged CPB time was associated with postoperative ECMO support (P<0.001), but use of DHCA, duration of aortic cross-clamp, and preoperative shock status were not associated with postoperative ECMO support (P=1.0, 0.141 and 0.73, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…29, 30 Consistent with other reported series, hypoplastic left heart syndrome (HLHS) was associated with high mortality in low body weight, and Norwood stage one palliation (S1P) performed on patients with low body weight was associated with more than double the risk. 6,21, 24 More effort is needed to improve outcome in this group.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Risk Stratification and Outcome of Cardiac Surgery for Patients With Body Weight <2,500g in an Asian Center

Chen

Chang

et al. 2014

Circ J

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk Stratification and Outcome of Cardiac Surgery for Patients With Body Weight <2,500g in an Asian Center

Chen

Chang

et al. 2014

Circ J

View full text Add to dashboard Cite

“…Several reports show higher mortality and morbidity rates in LBW infants with CHD compared with infants with normal BW 22, 23, 24. It is important to distinguish between LBW and SGA since they represent 2 different concepts.…”

Section: Discussionmentioning

confidence: 99%

Effect of Fetal Growth on 1‐Year Mortality in Neonates With Critical Congenital Heart Disease

Steurer

Baer

Burke

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundInfants with critical congenital heart disease (CCHD) are more likely to be small for gestational age (GA). It is unclear how this affects mortality. The authors investigated the effect of birth weight Z score on 1‐year mortality separately in preterm (GA <37 weeks), early‐term (GA 37–38 weeks), and full‐term (GA 39–42 weeks) infants with CCHD.Methods and ResultsLive‐born infants with CCHD and GA 22 to 42 weeks born in California 2007–2012 were included in the analysis. The primary predictor was Z score for birth weight and the primary outcome was 1‐year mortality. Multivariable logistic regression was used. Results are presented as adjusted odds ratios and 95% confidence intervals (CIs). The authors identified 6903 infants with CCHD. For preterm and full‐term infants, only a Z score for birth weight <−2 was associated with increased mortality compared with the reference group (Z score 0–0.5, adjusted odds ratio, 2.15 [95% CI, 1.1–4.21] and adjusted odds ratio, 3.93 [95% CI, 2.32–6.68], respectively). In contrast, in early‐term infants, the adjusted odds ratios for Z scores <−2, −2 to −1, and −1 to −0.5 were 3.42 (95% CI, 1.93–6.04), 1.78 (95% CI, 1.12–2.83), and 2.03 (95% CI, 1.27–3.23), respectively, versus the reference group.Conclusions GA seems to modify the effect of birth weight Z score on mortality in infants with CCHD. In preterm and full‐term infants, only the most severe small‐for‐GA infants (Z score <−2) were at increased risk for mortality, while, in early‐term infants, the risk extended to mild to moderate small‐for‐GA infants (Z score <−0.5). This information helps to identify high‐risk infants and is useful for surgical planning.

show abstract

“…In the preoperative setting, mechanical circulatory support is occasionally required in neonates who present with profound cyanosis and/or cardiogenic shock [8][9][10][11][12]. These neonates would include such patients as those with obstructed totally anomalous pulmonary venous connection, or tetralogy of Fallot with absent pulmonary valve syndrome.…”

Section: Preoperative Stabilizationmentioning

confidence: 99%

Perioperative Mechanical Circulatory Support in Children with Critical Heart Disease

Checchia

2011

Curr Treat Options Cardio Med

View full text Add to dashboard Cite

The treatment of cardiovascular failure in the perioperative period with the use of mechanical circulatory support is a well-recognized, well-developed, and commonly utilized treatment modality. Regardless of the exact circumstances of initiation, the use of a support device is a "bridge." Where there has been an acute myocardial insult, short-term assist devices can serve as a "bridge to immediate survival," a "bridge to recovery," or even a "bridge to the next decision." Mechanical circulatory support can serve as a treatment of cardiovascular decompensation caused by myocarditis, acute myocardial insult, low cardiac output following surgery, and congenital heart disease. The utilization of such support carries significant risks such as bleeding, infection, and thrombosis. However, these can be minimized in order to allow for the safe and effective deployment of this therapeutic strategy. One specific therapeutic domain in which these devices provide immediate impact is during cardiac arrest. Although outcomes of cardiac arrest remain poor, use of a mechanical device as an intervention has allowed salvage of otherwise certain mortality. However, it is important to note that the utility of support was most pronounced in patients that were not on either extreme of the survival prediction curve. This can be best summarized by the concept of "not too early, not too late." Therefore, it is the responsibility of the entire care team to find the appropriate patient population in which to "pull the trigger" on mechanical support as a therapy. This decision point is supported by a monitoring strategy that can be utilized to predict deterioration and intervene adequately. Most importantly, an effective monitoring strategy allows the practitioner to judge the effectiveness of treatment and support strategies and make adjustments in a timely manner, potentially with mechanical support in the perioperative period.

show abstract

Morbidity and mortality after surgery for congenital cardiac disease in the infant born with low weight

Abstract: Patients undergoing surgery during infancy for congenital cardiac disease who are born with low weight have a higher mortality and morbidity than those born with normal weight.

Cited by 76 publications

References 27 publications

Risk Stratification and Outcome of Cardiac Surgery for Patients With Body Weight <2,500g in an Asian Center

Risk Stratification and Outcome of Cardiac Surgery for Patients With Body Weight <2,500g in an Asian Center

Effect of Fetal Growth on 1‐Year Mortality in Neonates With Critical Congenital Heart Disease

Perioperative Mechanical Circulatory Support in Children with Critical Heart Disease

Contact Info

Product

Resources

About