and 2 other(s)
Background & Aims: Infants with duct-dependent congenital heart disease (DD-CHD) are sometimes born very preterm (<32 weeks’ gestation). These infants may require prolonged infusions of prostaglandin (PGE1) to maintain ductal patency, whilst attaining sufficient weight to undergo cardiac surgery. Literature on the outcomes of these patients is sparse. The objective was to describe mortality and morbidity of very preterm infants with DD-CHD, treated with PGE1. Methods: A review of medical records of very preterm infants born at the Royal Women’s Hospital, Melbourne, between 2006 and 2016 with DD-CHD, treated with PGE1 was undertaken. Results: 16 infants were identified, with a median (IQR) gestational age 30+2 weeks’ (29+6 to 31+2 weeks’), and birth weight 1275 g (1070 g to 1480 g). Eight (50%) were male. Twelve (75%) were diagnosed with DD-CHD antenatally, and 14 (88%) received antenatal corticosteroids. Nine (56%) infants had duct-dependent pulmonary circulation, five (31%) had duct-dependent systemic circulation and two (13%) had transposition of the great arteries. PGE1 was most often commenced on the first day of life, with a median (IQR) duration of treatment of 23 days (8 to 47 days). Ten (63%) infants were enterally fed whilst receiving PGE1. Five (31%) infants developed necrotising enterocolitis; two required surgery. Four (25%) infants died before hospital discharge; one infant dying prior to, and three infants after, cardiac surgery. Conclusions: Very preterm infants with DD-CHD have substantial morbidity and mortality. These findings are useful and important for treating clinicians when counselling parents of these high-risk infants.
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