Congenital heart disease in newborn infants: non-surgical death and surgical results
Ueda, K.; Nakano, H.; Saito, A.; Yokota, M.; Aoshima, M.; Shiraishi, Y.; Kyoku, I.; Kitano, M.; Shimada, I.
Nihon Kyobu Geka Gakkai 34(11): 1931-1936
1986
ISSN/ISBN: 0369-4739 PMID: 3819493 Document Number: 285104
Between April 1977 and March 1985, 138 newborns with congenital heart disease (CHD) were transferred to Shizuoka Children's Hospital because of generalized cyanosis or respiratory distress. Preoperative conditions, days of life, cardiac catheterization, operative methods, and prognosis were discussed, comparing the first half (1977-1981) (F) with the second half (1982-) (S). Especially, the relationships between the non-surgical death, which has been overlooked inspite of its much influence on the operative results, and surgical results were analysed. The patients increased from 67 in first 5 years (F) to 71 in second 3 years (S). More than half were under 7 days of life; 43 (68.3%) in F and 47 (66.2%) in S. The newborns, who were in shock at admission, was not decreased (N.S.); 12 (17.9%) in F and 11 (15.5%) in S. The non-surgical death, hospital death and hospital survival of 101 newborns, in which the non-surgical survival was excluded, were 15 (35.7%), 11 (26.2%), 16 (38.1%) in F respectively. The non-surgical death rate was higher than the hospital death rate in F. In contrast, though the hospital death rate in S (20; 33.95) was not diminished from F, the non-surgical death (7; 11.9%) was decreased remarkably (p<0.01) from F. Consequently, the hospital survival was increased from 16 (38.1%) in F to 32 (54.2%) in S (N.S.). The results of the treatment for CHD in newborn period should be discussed totally on not only surgical results but also non-surgical death. On the management of CHD in newborn infancy, the newborn transport system is essential in addition to the medical and surgical improvements.