Experience of echocardiography diagnosis and surgical treatment of neonatal critical congenital heart disease

Objective To review the infants with critical congenital heart disease(CHD)requiring neonatal cardiac surgery and summary echocardiographic diagnosis and surgical approaches in these patients.Methods Clinical data of 160 neonates with critical CHD treated in our center from Jan 2012 to Jan 2017 were reviewed.All the cases had severe cardiac or great vessel anomalies which tended to result in severe hypoxemia,acidosis,respiratory or circulatory failure and so on.Critical CHD may cause sudden death and need surgical or catheter-based intervention in the neonatal period.Results Preoperative echocardiography diagnosis included transposition of the great artery(50%),pulmonary atresia or severe pulmonary stenosis with intact ventricular septum(17.5%),interruption of the aorta arch,coarctation of the aorta(15%),total anomalous pulmonary venous connection(10.6%),truncus arteriosus(3.8%),Tetralogy of Fallot(1.9%),large ventricular septal defect(0.6%),and right atrial mass(0.6%).One hundred and forty neonates underwent surgical repairs,and the in-hospital mortality was 7.9%(134 neonates underwent one-staged corrective surgeries,4 neonates underwent palliative treatments,2 neonates underwent two-staged complete repairs).One hundred and twenty-two neonates were followed up after surgeries and the mean follow up time was(16.8±18.2)months.Only two infants received reoperations during the follow-up,the other infants recovered well.Conclusion This study demonstrates eight critical CHD types requiring neonatal cardiac surgeries in this patient cohort,patients developed cyanosis and pulmonary plethora.The outcome is satisfactory in the most infants after optimal surgeries.