From February 1982 to December 1991, 49 neonates and 105 infants in less than 3 months of age underwent open heart surgery in Seoul National University Hospital.
There were 98 males and 56 females, and their mean ages were 16 days in neonatal group and 67 days in early infant group. Their body weight and height were less than 3 percentile of normal developmental pattern. In order of decreasing incidence,
the
corrected conditions included transposition of great arteries with or without ventricular septal defect (43), isolated ventricular septal defect (34), total anomalous pulmonary venous return (21), pulmonary atresia with intact ventricular septum
(9) and
others (47) . Various corrective or palliative procedures were performed on these patients ;Arterial switch operation (36), patch closure for ventricular septal defect (34), Repair of total anomalous pulmonary venous return (21), RVOT
reconstruction for
congenital anomalies with compromised right ventricular outflow tract (17). Profound hypothermia and circulatory arrest were used in94 patients (61%): 42 patients (85.7%) for neonatal group and 52 patients (49.5%) for early infant group. The
durations
of circulatory interruption were within the safe margin according to the corresponding body temperature in most cases (84%). The hospital mortality was 36.4%;44.9% in neonatal group and 32.4% in infant group 1 to 3 months of age. The mortality
was
higher in cyanotic patients (46.6%), in those who underwent palliative procedures (57.8%), in patients whose circulatory arrest time was longer than safe periods (60%) and in patients who had long periods of cardiopulmonary bypss and aortic
cross-clamping. In conclusion, there has been mcreasing incidence of open heart surgery in neonates and early infants in recent years and the technique of deep hypothermia and circulatory arrest was applied in most of these patients, and the
mortality
was higher in cyanotic neonates who underwent palliative procedures and who had long cardiopulmonary by pass, aortic cross-clamping and circulatory arrest. (Korean J Thoracic Cardiovas Surg 1994; 27:180-185
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