Outcomes following surgery for congenital heart disease in low-birthweight infants

Simon Dimmick, Karen Walker, Nadia Badawi, Robert Halliday, Stephen G. Cooper, Ian A. Nicholson, Megan Sherwood, Richard B. Chard, Richard Hawker, Kai C. Lau, Owen Jones, Peter W. Grant, Gary F. Sholler, David S. Winlaw*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Aim: To describe cardiac surgery, survival and outcomes for low-birthweight (≤2500 g) infants undergoing surgery for congenital heart disease. Methods: Using data from a prospectively collected population-based database of admissions to neonatal intensive care units in New South Wales and the Australian Capital Territory, we identified all low-birthweight infants undergoing cardiac surgery between 1992 and 2001. Infants with only a persistent ductus arteriosus were excluded. Two-year cardiac and neurodevelopmental outcome data were sought from hospital medical records. Results: A total of 121 low-birthweight infants underwent cardiac surgery, of whom 34% had a congenital syndrome or non-cardiac birth defect. Most (81%) underwent a palliative surgical procedure in the neonatal period. There were 19 early (15.7%) and 19 late deaths giving a 2-year mortality of 31%. Factors associated with mortality included birthweight below 1500 g (P = 0.006), low weight at surgery (P = 0.028) and Apgar score at 1 min (P = 0.019). No single factor predicted 30-day mortality. By 2 years of age, 27 (33% of survivors) were known to have neurodevelopmental delay. Although 22 children are known to be developing normally, the neurodevelopmental status of 34 children was not known. Conclusions: These surgical data were comparable to previous single-institution studies. This group had a high risk of disability due to prematurity, low birthweight and associated conditions. There is a need to prospectively assess and manage neurodevelopmental outcomes in this group.

Original languageEnglish (US)
Pages (from-to)370-375
Number of pages6
JournalJournal of Paediatrics and Child Health
Volume43
Issue number5
DOIs
StatePublished - May 2007

Keywords

  • Congenital heart disease
  • Low-birthweight infant
  • Outcome
  • Paediatric surgery
  • Population based

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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