From January 1993 to April 1995, 27 neonates(under age of 30 days) underwent open heart surgery in the Department of Thoracic and Cardiovascular Surgery, Dong-A Medical Center. Mean age and weight were 12.1 days(2days~30days) and 3.29
kg(2.6~4.1kg)
respectively. Cardiac anomalies were simple complete transposition of great arteries(TGA) in ll neonates, TGA with coarctation of aorta(COA) in l, total anomalous pulmonary venous connection(TAPVC) in 5, double inlet right ventricle with TAPVC in
l,
interrupted aortic arch(IAA) with ventricular septal defect(VSD) in 3, pulmonary atresia(PA) with intact ventricular septum(IVS) in 3, pulmonary stenosis with IVS in l, Taussig-Bing anomaly with IAA in l, and hypoplastic left heart syndrome(HLHS)
in
I.
Postoperative complications were myocardial and/or pulmonary edema which caused open sternum in 13 patients(54.2%) acute renal failure(ARF) in 10(37.0%), intractable low cardiac output syndrome (LCOS) including weaning failure from
cardiopulmonary
bypass in 7(25.9%), bronchopulmonary dysplasia in l, wound infection in l, and paroxysmal supraventricular tachvcardia in l. Nine of 13 patients with postoperative open sternum were recovered with delayed sternal closure, and seven of 10 patients
survived postoperative ARF with peritoneal dialysis. There were 8 operative deaths(29.6%); 3 in the patients with simple complete TGA, l in TGA with COA, l in PA with IVS, I in Taussig-Bing anomaly with IAA, I in DIRV with TAPVC, and I in HLHS.
One
late
death occurred after arterial switch operation in simple TGA. The most common cause of death was low cardiac output syndrome. Our initial experience of open heart surgery in neonates showed high operative mortality and morbidity, especially in
complex
anomalies.
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