Evaluation of mortality and morbidity in patients operated congenital heart disease in neonatal period

Aim: Congenital heart diseases, which are the most common congenital anomaly, are among the causes of perinatal and infantile death. Survival in congenital heart diseases has increased with intervention done even in newborns. Hospital morbidity and neurodevelopmental delay are important problems to be avoided. The aim of this study is investigating effect of mortality, hospital morbidity and neurodevelopmental status on patients operated congenital heart disease in neonatal period. Methods: Hospital mortality, morbidity and neurodevelopmental status of living patients are defined in 142 neonates with operated congenital heart diseases, hospitalised in Cukurova Unıversity Balcali Hospital neonatal intensive care units between 2014-2018; the risk factors that are thought to effect these results, were investigated. Results: The number of deaths after the operation was 47 (33.1%). Motality was higher in patients who had low birth weight, two ventricles with no aortic arch obstruction, high RACHS-1 score, palliative operation, need early reoperation, high postoperative 12-hour lactate and glucose level, need inotropic support on postoperative fifth day, renal failure, need ECMO support. Renal failure was present in 8 (5.6%); AV block in 4 (2.8%); diaphragmatic paralysis in 5 (3.5%); infection in 39 (27.5%) patients. Three (2.1%) patients needed ECMO support. Early reoperation was required in 22 (15.5%) patients. Fifty-two patients (48.6%) had prolonged ventilation; 102 (71.8%) had prolonged hospitalization. While the number of patients who developed at least one morbidity was 116 (81.7%), 71 (61.2%) patients had multiple morbidity. It was observed that morbidity were high in patients who had longer mechanical ventilation and longer hospital stay. According to the neurodevelopmental test results, 28 (73.7%) patients were normal, 6 (15.8%) patients were dull normal, 4 (10.5%) patients were at upper normal level. Patients with higher outcomes had higher maternal educational level. Conclusion: Mortality and morbidity after neonatal cardiac surgery is still high. The main purpose after neonatal cardiac surgery is not only decreasing the mortality but also survival with as low morbidity as possible. The main purpose after neonatal cardiac surgery is healthy long life. Therefore not only low mortality is sufficent but also as low morbidity as possible is required. Key words: congenital heart diseases, neonatal congenital heart surgery, mortality, morbidity, neurodevelopment