TY - JOUR
T1 - Neonatal cardiac surgery in the new era
T2 - Lessons learned from 1000 consecutive cases
AU - Amir, Gabriel
AU - Frenkel, Georgy
AU - Bruckheimer, Elchanan
AU - Lowenthal, Alexander
AU - Rotstein, Amichay
AU - Katz, Jacob
AU - Zeitlin, Yelena
AU - Schiller, Ofer
AU - Birk, Einat
N1 - Publisher Copyright:
© 2016, Israel Medical Association. All rights reserved.
PY - 2016/11
Y1 - 2016/11
N2 - Background: neonatal cardiac surgery has evolved over the last 50 years with a large percentage of the patients achieving complete physiological repair in the neonatal period. The remaining patients achieve staged palliation with an increasing amount of success. Objectives: To report our experience with 1000 neonatal cardiac surgical procedures performed in the last 10 years. Methods: We conducted a retrospective analysis of surgical outcome in all neonatal patients who underwent cardiac surgery between January 2007 and July 2016 at Schneider Children’s Medical Center of Israel. Results: A total of 1003 neonates aged < 30 days underwent surgery for congenital heart defects at our center. Neonatal surgery accounted for 22.5% of all cardiac surgeries. Neonatal operative mortality was 7.3%, Operative mortality for individual lesions were: simple aortic coarctation (CoA) (198 patients, 2.5%), CoA with hypoplastic arch (24, 4%), CoA with ventricular septal defect (VSD) (84, 2.3%), transposition of the great arteries (TGA, simple and complex, 185, 6.3%), TGA with VSD (37, 0%), truncus arteriosus (26, 3.8%), interrupted aortic arch (25, 4%), Norwood Sano (71, 19.7%), neonatal tetralogy of Fallot (41, 0%), and shunt (131 patients, 12%). Conclusions: Neonatal surgical capabilities have improved substantially over the last decades. Excellent results can be expected for lesions that can be repaired to create biventricular circulation. Improved results can be attributed in part to the evolution of surgical strategies and assistive technologies, but essential is the collaborative effort of surgeons, cardiologists, anesthesiologists, and intensive care specialists acting as a cohesive team whose performance far exceeds the sum of its individual members’ contributions.
AB - Background: neonatal cardiac surgery has evolved over the last 50 years with a large percentage of the patients achieving complete physiological repair in the neonatal period. The remaining patients achieve staged palliation with an increasing amount of success. Objectives: To report our experience with 1000 neonatal cardiac surgical procedures performed in the last 10 years. Methods: We conducted a retrospective analysis of surgical outcome in all neonatal patients who underwent cardiac surgery between January 2007 and July 2016 at Schneider Children’s Medical Center of Israel. Results: A total of 1003 neonates aged < 30 days underwent surgery for congenital heart defects at our center. Neonatal surgery accounted for 22.5% of all cardiac surgeries. Neonatal operative mortality was 7.3%, Operative mortality for individual lesions were: simple aortic coarctation (CoA) (198 patients, 2.5%), CoA with hypoplastic arch (24, 4%), CoA with ventricular septal defect (VSD) (84, 2.3%), transposition of the great arteries (TGA, simple and complex, 185, 6.3%), TGA with VSD (37, 0%), truncus arteriosus (26, 3.8%), interrupted aortic arch (25, 4%), Norwood Sano (71, 19.7%), neonatal tetralogy of Fallot (41, 0%), and shunt (131 patients, 12%). Conclusions: Neonatal surgical capabilities have improved substantially over the last decades. Excellent results can be expected for lesions that can be repaired to create biventricular circulation. Improved results can be attributed in part to the evolution of surgical strategies and assistive technologies, but essential is the collaborative effort of surgeons, cardiologists, anesthesiologists, and intensive care specialists acting as a cohesive team whose performance far exceeds the sum of its individual members’ contributions.
KW - Cardiac surgery
KW - Cardiac team
KW - Mortality
KW - Neonate
UR - http://www.scopus.com/inward/record.url?scp=84995584058&partnerID=8YFLogxK
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C2 - 28466610
AN - SCOPUS:84995584058
SN - 1565-1088
VL - 18
SP - 645
EP - 648
JO - Israel Medical Association Journal
JF - Israel Medical Association Journal
IS - 11
ER -