• F Haas, C S Goldberg, R G Ohye, R S Mosca, and E L Bove.
• Division of Pediatric Cardiovascular Surgery, Section of Cardiac Surgery, F7830 C.S. Mott Children's Hospital, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
• Eur J Cardiothorac Surg. 2000 Jun 1;17(6):643-7.

ObjectivePrevious reports have suggested that prematurity and low birth weight are risk factors for definitive surgical intervention in congenital cardiac malformations. The following data review our experience with primary repair of the complex malformation of aortic arch obstruction with ventricular septal defect (VSD) in this patient population.MethodsSince 1988, 21 consecutive preterm (ResultsThe overall hospital mortality was 14% (3/21). Death was related to low cardiac output in association with severe subaortic stenosis (n=2) and sepsis (n=1). Late mortality occurred in three patients, two of which were non-cardiac. The mean follow-up was 33 months. Two patients had significant recurrent arch obstruction, which was successfully relieved by balloon angioplasty and surgical correction in one each. The survival at 30 days, and at 1 and 3 years was 86, 76 and 70%, respectively.ConclusionsComplete primary repair of aortic arch obstruction with VSD can be achieved with good results, even in the preterm and low birth weight infant. Therefore, early surgical repair of this congenital malformation is recommended.

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