Complications of Corrective Surgery in Preterm Neonates with Congenital Heart Defects: What is the Solution?

Document Type: letter to the Editor

Authors

1 Cardiovascular Diseases Research Center, Department of Pediatric Cardiology, Faculty of Medicine, Birjand University of Medical Sciences, Vali-Asr Hospital, Birjand, Iran

2 Cardiovascular Research Center, Department of Cardiac Surgery, Faculty of Medicine, Birjand University of Medical Sciences, Razi Hospital, Birjand, Iran

3 Department of Neurology, Faculty of Medicine, Birjand University of Medical Sciences, Vali-Asr Hospital, Birjand, Iran

Abstract

Mild congenital heart defects require no treatment, while severe forms of these diseases need immediate interventions. There are several limits in preterm neonates on drug interventions, interventional procedures, and even heart surgery due to the prematurity of pulmonary, renal, and central nervous systems. Considering the mentioned points, the collaboration of other medical professions, particularly neonatologists, is needed in the treatment of these newborns. The application of surgical and interventional instruments are associated with limitations owing to the low birth weight in these neonates. Therefore, it is essential to review and modify the treatment program for this group of patients. By the advancement of surgical treatments mainly in fetal course and the approval of their efficiency, designing a new interdisciplinary field is necessary. In developing countries, such as Iran, the prenatal diagnosis of congenital heart diseases is difficult because of the lack of expertise in this area. On the other hand, abortion seems to be problematic due to the religious reasons. The legal gestational age for abortion is less than 20 weeks, and the probability of dealing with these kinds of diseases is more than developed countries.
During several years, we encountered at least 15 cases with the above-mentioned criteria, five of whom required an immediate intervention. Three patients were dextro-Transpotion of the great arteries, one patient had pulmonary atresia with ventricular septal defect, and the two other ones were suffering from coarctation of the aorta and tricuspid atresia type 1A, who all underwent the palliative surgery.

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