Postoperative extra-corporeal mechanical support in neonates and infants. Impact of residual lesions on outcome

• Published in: The Thoracic and Cardiovascular Surgeon
• Main Authors: Horke, A, Meschenmoser, L, Tzanavaros, I, Rein, J
• Format: Conference Proceeding
• Language: English
• Published: 01.02.2010
• ISSN: 0171-6425; 1439-1902
• DOI: 10.1055/s-0029-1246772

Objectives: In complex congenital cardiac surgery a better survival can be achived by the postoperative use of mechanical support (ECMO). We examined a single institution experience with postoperative ECMOs in neonates and infants aiming to identify outcome predictors. Methods: From January 2000 until August 2009 we operated on 1213 children with congenital heart defects with a low hospital mortality of 2.56%. Seven patients needed postoperative mechanical support (0.58%). Hospital records of all children who required postoperative ECMO at our institution were reviewed. Results: In hospital mortality was 71.4% (5/7 patients). During follow-up 1 patient died 2.5 years after initial correction. All three patients without residual lesions survived. Among 4 patients with residual lesions (2 patients with RVOT stenosis, 1 with too small left ventricle, 1 with thrombotic closure of fenestration of TCPC) 2 were corrected and survived whereas 2 without correction died. Conclusion: ECMO plays a valuable role in neonates and infants with low cardiac output state following cardiac surgery. More than one third of those patients can be salvaged. Residual cardiac lesions seem to play a negative predictor factor and have to be treated aggresively.