Survival benefits of the wait-and-grow approach in small babies (≤2000 g) requiring heart surgery

• Published in: JTCVS open 2024-04, Vol.18, p.156-166
• Main Authors: Henmi, Soichiro, Venna, Alyssia, Haverty, Mitchell C., Mehta, Rittal, Desai, Manan, Tongut, Aybala, Yerebakan, Can, Donofrio, Mary T., Munoz, Ricardo A., d’Udekem, Yves
• Format: Article
• Language: English
• Subjects: cardiovascular surgery; Congenital: Single Ventricle; delayed surgery; low birth weight; single ventricle
• ISSN: 2666-2736; 2666-2736
• DOI: 10.1016/j.xjon.2024.01.006

The best approach to minimize the observed higher mortality of newborn infants with low birth weight who require congenital heart surgery is unclear. This retrospective study was designed to review outcomes of newborn infants weighing 3500 g at surgery were excluded. Median age was 24 days and weight at the time of surgery was 1920 g. Twenty-six (25%) operative mortalities were recorded. Median follow-up period was 2.7 years. The 1- and 3-year overall Kaplan-Meier survival estimate was 72.4% ± 4.5% and 69.1% ± 4.6%. The 1-year survival of patients who had a weight increase >300 g from birth to surgery was far superior to the survival of those who did not achieve such a weight gain (81.4% ± 5.6% vs 64.0% ± 6.7%; log-rank P = .04). By multivariable Cox-hazard regression analysis, the independent predictor of 1-year mortality was genetic syndrome (hazard ratio, 3.54; 95% CI, 1.67-7.82; P