Long-distance transport of neonates with transposition of the great arteries for the arterial switch operation: A 26-year Western Australian experience

被引:7
作者
Paul, Saritha [1 ]
Resnick, Steven [1 ,3 ,5 ]
Gardiner, Katharine [1 ]
Ramsay, James M. [2 ,4 ]
机构
[1] Princess Margaret Hosp Children, Neonatol Clin Care Unit, Perth, WA 6008, Australia
[2] Princess Margaret Hosp Children, Childrens Cardiac Ctr, Perth, WA 6008, Australia
[3] Univ Western Australia, Ctr Neonatal Res & Educ, Perth, WA 6009, Australia
[4] Univ Western Australia, Sch Paediat & Child Hlth, Perth, WA 6009, Australia
[5] Newborn Emergency Transport Serv, Perth, WA, Australia
关键词
arterial switch operation; neonatal transport; transposition of great arteries; BALLOON ATRIAL SEPTOSTOMY; PEDIATRIC CARDIAC-SURGERY; CONGENITAL HEART-DISEASE; PREOPERATIVE BRAIN-INJURY; IN-HOSPITAL MORTALITY; NEWBORN-INFANTS; CASE VOLUME; OUTCOMES; CHILDREN; DEFECTS;
D O I
10.1111/jpc.12782
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
AimThere is evidence that outcomes of complex paediatric cardiac procedures including the arterial switch operation (ASO) for transposition of the great arteries (TGA) are improved when performed at higher volume centres. While in utero transport for surgery is considered ideal, antenatal detection rates of TGA are low. Long-distance transport of post-natally diagnosed neonates has the potential to destabilise the patient's clinical condition. Since 1986, many neonates with TGA have been transported interstate from Perth to Melbourne or Brisbane for ASO surgery. The aim of this study was to review the Western Australian experience of interstate transport of newborns with TGA for ASO, noting transport complications and comparing the early mortality of these patients with published outcomes of the ASO from Royal Children's Hospital (RCH), Melbourne. MethodIn this retrospective cohort study, we reviewed the neonatal and cardiology databases and medical records to identify infants with TGA born between 1986 and 2011 and requiring ASO surgery during the neonatal period. ResultsOver 26years, 80 neonates were transferred interstate for ASO surgery. Twelve infants required ventilation, 36 needed prostaglandin (prostaglandin E1) infusion and 3 inotropic support. There was no mortality during transport and there was a single early post-operative death. This early mortality of 1.2% compares favourably with the RCH mortality of 2.8% from a recently published review of early outcomes for ASO. ConclusionsWhen in utero transport is not possible, long-distance transport of neonates with TGA can be safely undertaken, with no evidence of increased transport mortality/ major morbidity or higher early surgical mortality.
引用
收藏
页码:590 / 594
页数:5
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