A five year review of neonatal cardiac surgery in the Philippine Heart Center.

BACKGROUND: Neonates with congenital heart defects are more hemodynamically unstable than older children. There is a high risk of mortality in definitive repair as well as with palliative surgery. Timing of surgery was a controversy. In the advent of new technology mortality and morbidity rate has decreased in developed countries hence more neonates undergo definitive repair. Hence, this study is aimed to describe the experience of surgical treatment of neonates with congenital heart disease in the Philippine Heart Center, to assess the outcome and mortality of neonates undergoing cardiac surgery for congenital heart disease, to determine factors associated with mortality and morbidity of patients undergoing cardiac surgery.

METHODS: Between August 1999 to August 2005, consecutive patients less than 30 days old who underwent palliative or corrective surgery in the Philippine Heart Center was reviewed. Data on age and weight and height at operation, primary diagnosis, type of surgery, use of cardiopulmonary bypass were taken. Outcome analysis include incidence and type of complications, duration of ventilation and intensive care, and hospital stay.

RESULTS: Most of the congenital heart defects were that of RV and Pulmonary outflow abnormalities. There were more patients who underwent corrective surgery. Risk analysis for morbidity and mortality showed that age, weight, height, type of operation and use of cardiopulmonary bypass were not significant. T-test of group statistics showed that mortality and morbidity was related to the length of ventilatory support and length of intensive care stay with a significant p value on 0.015 and 0.001 respectively. Most common post operative problems were related to the pulmonary system.

CONCLUSION: According to this study age, weight and height, type of surgery and the use of cardiopulmonary bypass were not considered as a risk factor. A surgical approach in this particular group of patients can be performed with acceptable outcome. However this study carries the limitations related to its retrospective character and the small sample size involved congenital heart defects. A bigger sample size would be able to predict a better outcome. (Author)