[Emergency in neo-natal surgery. High risks in forty-one cases (author's transl)]. / L'urgence en chirurgie cardiaque du petit enfant. Etude des facteurs de gravité à propos de 41 cas.

ABSTRACT

41 babies were operated upon in emergency in the cardiac surgery department. 11 of them were submitted to open heart surgery and 30 were operated without extra corporeal circulation. Amongst them, there were 21 coarctations of thoracic aorta either isolated or associated with other cardiac malformations. 13 of them, presented a pericardial effusion, and the mean age was 3 months. First of all, the notion of emergency in cardiac surgery of the new-born is stressed. Then, premedication and technic of anaesthesia are shortly described. The authors insist on the frequency of lethal cardiac fibrillation occurring at the opening of pericardium in case of coarctations of aorta complicated by pericardial effusion. Prevention of this accident is possible if at the beginning of anaesthesia the baby lies in a proclive position. On the opposite, bradycardia occurring at the opening of the pericardium or during pulmonary artery banding have a good prognosis. Lastly, the authors insist on the high risk of this surgery in the baby (25 p. cent of mortality) and 80 p. cent under 6 months of age and the high mortality of iterative operations.