Short-term outcomes and risk factors for mortality in neonatal cardiac surgeries with cardiopulmonary bypass: a 5-year single-center report.

Background: Open-heart surgeries carry significantly greater risks in neonates than in older children. The current study aimed to analyze the short-term outcomes and risk factors for mortality in neonates undergoing cardiac surgeries.

Methods: This retrospective analysis included neonates who underwent cardiac surgeries with cardiopulmonary bypass (CPB) at our center between 2019 and 2023. Perioperative and operative factors were collected, and in-hospital outcomes and risk factors for mortality were identified.

Results: We analyzed the medical records of 190 neonates, including 111 males and 79 females. The median age at the time of surgery was 15 days, with a median weight of 3.2 kg. The overall mortality rate was 11.6%. Major postoperative complications included infection (48.9%), low cardiac output (48.4%), hepatic insufficiency (24.9%), acute kidney injury (22.1%), unplanned reintervention (13.1%), intracranial hemorrhage (3.7%), and cerebral infarction (0.5%). Multivariable analysis identified prolonged CPB time (odds ratio (OR)=1.018, p=0.014), Risk Stratification for Congenital Heart Surgery (RASCH-2) categories of ≥4 (OR=11.927, p=0.026), extracorporeal membrane oxygenation (ECMO) duration (OR=1.606, p=0.036), and peritoneal hemodialysis (OR=9.252, p=0.014) as significant predictors for mortality.

Conclusions: Despite advancements in recent decades, continued vigilance is required to further reduce mortality rates among neonates undergoing cardiac surgeries.