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Review
. 2022 Sep;38(9):1235-1240.
doi: 10.1007/s00383-022-05178-z. Epub 2022 Jul 15.

How should we treat representative neonatal surgical diseases with congenital heart disease?

Mitsuru Muto #  1 , Koshiro Sugita #  2 , Tomoyuki Matsuba  3 , Chihiro Kedoin  2 , Mayu Matsui  2 , Shinichiro Ikoma  4 , Masakazu Murakami  2 , Keisuke Yano  2 , Shun Onishi  2 , Toshio Harumatsu  2 , Koji Yamada  2 , Waka Yamada  2 , Makoto Matsukubo  2 , Takafumi Kawano  4 , Seiro Machigashira  4 , Motofumi Torikai  4 , Tatsuru Kaji  5 , Satoshi Ibara  6 , Yutaka Imoto  3 , Yoshiharu Soga  3 , Satoshi Ieiri  2
Affiliations
Review

How should we treat representative neonatal surgical diseases with congenital heart disease?

Mitsuru Muto et al. Pediatr Surg Int. 2022 Sep.

Abstract

Purpose: Representative neonatal surgical diseases are often complicated by congenital heart disease (CHD). We reviewed our decade of experience from the perspective of the prognosis and report on the management of infants with CHD.

Methods: Cases with and without CHD between 2011 and 2020 were retrospectively compared. Qualitative data were analyzed using a chi-square test with Yates' correction, and quantitative data were compared using Student's t-test.

Results: Of the 275 neonatal surgical cases, 36 had CHD (13.1%). Ventricular septal defect was the most common cardiac anomaly, followed by atrial septal defect. Esophageal atresia showed the highest complication rate of CHD (43.8%, 14/32) followed by duodenal atresia (38.5%, 10/26). The mortality rates of patients with and without CHD (22.2% [8/36] vs. 1.3% [3/239]) were significantly different (χ2 = 30.6, p < 0.0001). Of the eight deaths with CHD, six patients had cyanotic complex CHD. Notably, four of these patients died from progression of inappropriate hemodynamics in the remote period after definitive non-cardiac surgery.

Conclusion: Considering its high-mortality, the presence of CHD, especially cyanotic heart disease, is an important issue to consider in the treatment of neonatal surgical diseases. Pediatric surgeons should be alert for changes in hemodynamics after surgery, as these may affect mortality.

Keywords: Congenital heart disease; Cyanotic heart disease; Hemodynamics; Mortality; Neonatal surgical disease.

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