Chirurgie cardiaque chez le nouveau-né et le nourrisson

Abstract

During the past five years, 127 newborn infants with marked anoxia, severe cardiac failure or respiratory problems secondary to a cardiac lesion were operated upon at l'Hôpital Ste-Justine, Montreal, Quebec.

Infants in cardiorespiratory distress from a cardiac lesion for which the surgical treatment is well established, such as complicated coarctation of the aorta, were either cured or improved in 78% of cases. The fatal outcome following medical treatment of patients suffering from lesions for which the surgical treatment is not yet well established, e.g. interruption of the aortic arch, led us to operate upon these infants with the hope of salvaging some of them despite the high surgical risk.

The decision to operate was usually based on clinical grounds; however, cine-angiocardiography was at times required to establish the exact diagnosis. Light anesthesia was essential to the success of the operation. Postoperative care was facilitated by a team of nurses well experienced in the treatment of newborn subjects with heart lesions. Fluids were administered in a minimum quantity of 700 c.c./m.² for 24 hours, and potassium was the only electrolyte added to the replacement fluids. Respiratory problems were reduced to a minimum by active physiotherapy. However, intubation with aspiration of tracheobronchial secretions was carried out when necessary.

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