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DOI: 10.1055/s-0029-1246847
Is low weight in congenital cardiac surgery still a risk factor?
Due to improvements congenital cardiac surgery in neonates can be performed with proper results. Despite continuous management enhancement of premature or small for gestational age newborns it is reported that low weight remains a risk factor for cardiac surgery with mortality rates in infants <2.5kg ranging from 10–45%. The Aristotle Score was developed to evaluate the quality of care. From September 1998 to February 2008, n=564 consecutive patients weighing 4kg and less underwent cardiac surgery at our centre.
We retrospectively formed two groups according to their weight at operation. Group included patients weighing less or equal 2.5kg (n=87) and was compared with Group2 with weight >2.5 to 4kg (n=477). Furthermore we analyzed the predictive value of the Aristotle Basic Complexity scores. There were 23 hospital death with a overall mortality rate of 4%. The early mortality rate in Group1 was 10.3% (14.8% on-pump, 3% off-pump) compared to GroupII with 2.9% (3.4 on-pump, 1% off-pump). In Group1 35.6% of the patients received a palliative procedure whereas the correction rate in Group II was high with 75.3%. Early mortality was high after palliation in Group1 n=7 (22.6% of all palliations), compared to Group2 n=10 (8.5% of all palliations). The highest mortality was recognizable in Group1 with functional single ventricle after on-pump palliation (40%). Congenital cardiac surgery in low weight infants can be performed with reasonable results. Especially on-pump palliation in single ventricle morphology is associated with higher mortality in low weight neonates.