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. 2024 Jan-Feb;17(1):13-18.
doi: 10.4103/apc.apc_3_24. Epub 2024 May 24.

Open-heart surgery in preterm infants: A single-center experience

Danish Memon  1   2 , Praveen Reddy Bayya  3 , Perraju Bendapudi  4 , Jessin Puliparambil Jayashankar  5 , Brijesh Parayaru Kottayil  3 , Balaji Srimurugan  3 , Raman Krishna Kumar  1
Affiliations

Open-heart surgery in preterm infants: A single-center experience

Danish Memon et al. Ann Pediatr Cardiol. 2024 Jan-Feb.

Abstract

Background: Open-heart surgery is challenging in preterm neonates and infants, and its feasibility in low-resource settings has not been defined. We describe our institutional experience with open-heart surgeries performed on consecutive preterm infants.

Materials methods and results: This was a single-center retrospective cohort from a tertiary hospital in Southern India and included consecutive preterm neonates (<37 weeks) admitted for open-heart surgery. This report is limited to babies who were <3 months at the surgery. The salient features of the 15 preterm included twin gestation: 7 (46.7%); median gestational age at birth: 35 weeks (28-36 weeks); median corrected gestational age at surgery: 37 weeks (33-40 weeks); birth weight: 1.75 kg (1.0-2.6 kg); weight at surgery: 1.8 kg (1.2-2.9 kg); and small for gestational age: 12 (80%). The heart defects included transposition of the great arteries (7), total anomalous pulmonary venous return (3), large ventricular septal defect (VSD) (1), and VSD with coarctation of the aorta (4). Eleven (73%) were mechanically ventilated preoperatively and five had preoperative sepsis. The mean cardiopulmonary bypass time was 169.7 ± 61.5 min, and cross-clamp time was 99.7 ± 43.8 min. There was no inhospital mortality; one baby expired during follow-up at 1 month. Postoperative mechanical ventilation duration was 126.50 h (84.25-231.50 h), and intensive care unit stay was 13.5 days (9-20.8). The total hospital stay was 39 days (11-95 days). Two children (13.3%) had postoperative sepsis.

Conclusion: Through collaborative multidisciplinary management, excellent outcomes are feasible in low-resource environments for selected preterm neonates undergoing corrective open-heart operations.

Keywords: Congenital heart surgery; low resource environments; preterm.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
The heart of a preterm child weighing 1.8 kg. This is the postoperative picture of an arterial switch operation done for the transposition of the great arteries
Figure 2
Figure 2
The weight gain trends for the patients during follow-up
See this image and copyright information in PMC

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