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KMID : 0364019950280010011
Korean Journal of Thoracic and Cardiovascular Surgery
1995 Volume.28 No. 1 p.11 ~ p.17
Open Heart Surgery in Infancy
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Abstract
Fourty-three infants undrewent intracardiac repaires within the first 12 months of life. Mean age was 7 months and mean weight was 6.7kg. A quarter of them were below 5kg. Overall mortality including complex anomalies was 17.9%.
Thirty-four infants with a ventricular septal defect (VSD) were treated. Three infants (8.8%) died in the early postoperative period, but only one (3.7%) of the infants without having associated lesions died. VSD was repaired either by the
incision
on
the rigth atrium, pulmonary artery, or rigth ventricle. Postoperative right bundle branch block (RBBB) occurrence was different according to the approach:30.8% in pulmonary arteriotomy, 37.5% in atriotomy, and 42.8% in ventriculotomy.
Surgically induced heart block did not occur in any patient, but 10 had temporary arrhythmia, and 11 patients were under temporary pacing from one day to 4 days without any persisting rhythm disturbances.
Pulmonary hypertension was present in 29 infants preoperatively, and seven of them developed postoperative elevation of the pressure. Infants complicated with pulmonary hypertensive crisis were managed successfully. Inotropics were necessary in
55.8% of
the infants and vasodilators in 37.2%. Platelet transfusion was needed in 10 cases who required 272 ml in average, but one who died from
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