All issues > Volume 52(4); 2009

Original Article

Korean J Pediatr. 2009;52(4):481-487. Published online April 15, 2009.

Clinical course and prognosis of hemodynamically significant congenital heart defects in very low birth weight infants

Hye Soo HS Yoo¹, Ji Eun JE Kim¹, Soo Kyoung SK Park¹, Hyun Ju HJ Seo¹, Yoo Jin YJ Jeong¹, Seo Heui SH Chio¹, Soo In SI Jeong¹, Sung Hoon SH Kim¹, Ji Hyuk JH Yang², June J Huh¹, Yun Sil YS Chang¹, Tae Gook TG Jun², I Seok IS Kang¹, Won Soon WS Park¹, Pyo Won PW Park², Heung Jae HJ Lee¹

¹Department of pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
¹Department of pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
²Department of thoracic and cardiovascular surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence Won Soon WS Park ,Email: wonspark@skku.edu

Abstract

Purpose
: This study investigated the clinical course and prognostic factor of very low birth weight infants (VLBWI) with hemodynamically significant congenital heart defects (CHDs).
Methods
: Medical records of 1,098 VLBWI with birth weight <1,500 g who had been admitted to the neonatal intensive care unit of Samsung Medical Center from October 1994 to December 2007 were reviewed retrospectively. The data for these patients with hemodynamically significant CHD (n=33) were compared with those without CHD (n=1,065).
Results
: The incidence of CHD was 3.0% (33 patients) 7 patients (21%) had CHD combined with the congenital abnormalities or chromosomal disorders. The most common CHD was a ventricular septal defect. The incidence of intrauterine growth retardation was higher in patients with CHD than in patients without CHD (34% vs. 20%), but there were no significant differences in gestational age, birth weight, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, severe intraventricular hemorrhage (≥Gr III), and periventricular leukomalacia. Cardiac surgery was performed on 13 patients (39%). Nine patients received staged operations, and 10 patients received early intervention. The overall mortality in patients who had CHD was higher than in the patients who did not have CHD (27% vs. 16%). In patients with CHD, congenital abnormalities or chromosomal disorders were more important factors for increased mortality (86% vs. 11%) than the degree of complexity of CHD (19% vs. 42%).
Conclusion
: The most important prognostic factors of VLBWI with CHD are the associated congenital abnormalities or chromosomal disorders.

Keywords :Infant, Very Low Birth Weight, Congenital Heart Defects, Congenital Abnormalities, Chromosome Disorders