Outcomes of critical congenital heart disease requiring emergent neonatal cardiac intervention

Prenatal Diagnosis
Jay D PruetzMark S Sklansky

Abstract

The aim of this study was to evaluate outcomes for neonates with critical congenital heart disease (CHD) requiring emergent neonatal cardiac intervention (ENCI). Neonates < 30 days of age that underwent ENCI at <48 h of age were retrospectively enrolled over a 2-year period. Forty-seven neonates met inclusion criteria for ENCI comprising nine cardiac defects that underwent 25 catheterizations and 22 cardiothoracic surgeries. The main groups were d-transposition of the great arteries (DTGA) and total anomalous pulmonary venous return (TAPVR). Prenatal detection was 38% overall: higher for single ventricle (86%) and heterotaxy (75%) than for DTGA (28%) or TAPVR (13%). Mortality was 11.1% (2/18) in prenatally diagnosed versus 13.8% (4/29) in postnatally diagnosed neonates (p = 0.86). Prenatal detection was associated with shorter mean hospital stay: 16.8 versus 30.3 days (p = 0.03). Prenatally diagnosed patients had lower preoperative inotropic scores (p = 0.02), less acidosis (pH; p = 0.09), but decreased likelihood of spontaneous labor (p = 0.01), lower gestational age (p = 0.01), and lower birth weight (p = 0.01). Fewer deaths occurred in neonates with prenatal detection of their critical CHD requiring ENCI. However, there was ...Continue Reading

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Related Concepts

Emergency Care
Congenital Heart Defects
Antenatal Screening Procedures
Retrospective Studies
Neonatal Intensive Care
Acidosis
Arteries
Catheterization
Heart
Scimitar Syndrome

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