Introduction: Given the low surgical mortality after contemporary neonatal cardiac surgery (Heart Center Leipzig, 1998 – 2006, N=439, 30 days mortality = 5,2 %) this study focused on morbidity, psychomotor development, social aspects, and quality of life.
Methods: Pilot study. Structured questionnaires were separately sent to parents and pediatricians of 59 consecutive neonates (d-transposition of great arteries=15, coarctation of the aorta=14, hypoplastic left heart syndrome=10, tetralogy of Fallot=5, pulmonary atresia with ventricular septal defect=4, and other=11) after corrective (N=42) or palliative (N=17) cardiac surgery operated over a period of 1 year (median age at surgery = 6 days, median Aristotle complexity score = 9.0). Postoperative data were retrieved from medical records.
Results: The median hospital stay was 28 days (8-169), including median of 12 d on ICU and 4.1 ventilation days. Secondary chest closure was performed in 16/59 (27.1%), postoperative ECMO was necessary in 2/59 (3.4%) and non-obligatory surgical/catheter re-interventions (those given by staged surgical strategy excluded) in 23/59 (38,9%) of patients. One early (1.7%) and 4 late (6.8%) death occured. Completed questionnaires could be obtained from 31/64 survivors at a median age of 2.3 years. More than 80% of children had an overall normal development, 65% parents stated a normal exercise tolerance, 86% normal speech comprehension, 48% normal active speech, 17,4% mild behavioural disorders, and 21,7% concentration difficulties.
Conclusion: Despite high complexity and postoperattive morbidity neonatal cardiac surgery carries normal psychomotor development in the majority and acceptable extent of negative social impact on the children´s families.