THE OUTCOME OF CARDIAC OPERATIONS IN INFANTS WEIGHING 2 KILOGRAMS OR LESS

Objective: A review of our recent experience of operating on infants w eighing 2 kg or less who had congenital heart disease was performed to determine the outcome of early surgical repair or palliation. Methods : A retrospective review of hospital records was performed for infants who weighed 2 kg or less and who were identified to have undergone ca rdiac operation at our institution January 1992 to June 1997, The data collected included age, weight, gestational age, cardiac diagnosis, s urgical procedure, and outcome measures such as length of stay, morbid ity, and mortality rate, Outpatient charts were reviewed for follow-up survival areal cardiac status. Results: Thirty-three operations were performed on 30 patients. Median age at operation was 19.5 days (1 to 140 days), and median weight was 4.8 kg (1.1 to 2.0 kg). Cardiac diagn oses varied, with coarctation of the aorta and tetralogy of Fallot mos t common. Twenty-four patients were horn at 37 or fewer weeks' gestati on. Hospital survival was 83% with no difference in mortality rates ba sed on age, weight, or type of surgical procedure. Premature infants t ended to have worse hospital survival. Median postoperative length of stay was 39 days (6 to 122 days), Median duration of mechanical ventil ation in survivors was 6 days (2 to 24 days). Neurologic complications were documented in eight patients. Of the 25 hospital survivors, 20 ( 80%) are alive with good cardiac status at a mean follow-up of 13 mont hs. Conclusion: Cardiac operations in a selected group of infants weig hing 2 kg or less can provide acceptable hospital survival. In most in stances, complete repair is possible with good medium-term outcome in the survivors. Investigation into neurologic outcomes in these patient s is warranted.