Amjad Mahmood, Afzal Ahmed, Waqar Ahmed.
Outcome of Surgery of Congenital Heart Disease at AFIC/NIHD, Rawalpindi Pakistan in year 2000.
Pak J Cardiol Jan ;12(3):67-71.

Surgery of congenital heart disease is palliative as well as curative and outcome of this surgery depends upon nature and gravity of lesion, facilities of operation theatre, expertise of surgeons, anesthetists and paramedical staff, postoperative intensive care, prediction and timely management of post operative complications. A non randomized, non experimental study was carried out to analyze the postoperative complications of congenital cardiac surgeries at AFIC/NIHD Rawalpindi. All children up to 12 years of age undergoing operative procedures of their congenital cardiac lesions in year 2000 were followed up for complications. There were total 202 surgeries up to 12 years of age in year 2000. Overall mortality rate was 10.3%, being maximum of total correction (25%) and minimum for ASD closure and pulmonary volvotomy (0%). Mortalities of other surgeries were; B-T shunt 16%, mitral valve replacement 16%, PA banding 14%,VSD closure 11.3% and PDA ligation 2.2%. Regarding etiology of these mortalities RV failure complicated by fluid retention and deranged hemodynamics for total correction, shunt block for B-T shunt, respiratory infection superimposed by compromised heart for PA banding and aspiration pneumonia for PDA ligation. Out of these mortalities about 75% were due to surgeries of registrar surgeons. This rate may be reduced by more experience and formulating structured training. Thorough evaluation revealed that scrupulous preoperative assesment by echocardiography, screening tests for sepsis, surgery in expert hands, meticulous cardiac anesthetic care, prediction and urgent treatment of post operative complications, intensive postoperative, management and regular follow-up with clinical and echocardiographic evaluation can reduce the incidence of mortality and morbidity from these operations.

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