Cardiopulmonary bypass surgery successfully performed by the Cardiothoracic Surgery Department for a premature infant weighing 1.9kg

From:Children’s Hospital of Soochow University    Release time:2019-11-04

A few days ago, the Cardiothoracic Surgery Department of our hospital performed a cardiopulmonary bypass surgery for a premature infant weighing only 1.9kg. The operation was successfully carried out with the deep hypothermic circulatory technology and selective cerebral perfusion. This child is a smaller twin, who was prematurely born at 33 weeks of pregnancy with a weight of only 1.5kg. The baby was transferred to our hospital by our collaborative hospital via the “green channel”. The baby was diagnosed with severe cardiovascular malformations after birth: the main arteries were severely constricted with aortic arch dysplasia, patent ductus arteriosus and atrial septal defect. According to the usual experience, performing cardiac operation under direct vision on children with such low body weight not only puts forward extremely high requirements for the surgical operation, but the potential damage of the whole body organs caused by extracorporeal circulation cannot be ignored either. Hence, the surgery involves great risks and huge challenges. Moreover, complications such as heart failure, central nervous system damage and renal dysfunction are also prone to occur after surgery. According to statistics, in a neonatal heart surgery, the perioperative mortality rate of an infant weighing less than 2.5kg is much higher than that of an infant weighing over 2.5kg.


Because the cardiovascular malformation of the baby, the blood circulation of the body should be maintained by the arterial catheter, while the arterial catheter is likely to be closed at any time after birth, which means the baby’s condition may deteriorate at any time while waiting for the operation. As expected, 2 weeks after birth, the weight of the baby reached 1.9kg, but there were symptoms like polypnea and difficulty in sucking the breast. Both the chest X-ray and cardiac examination indicates that the heart failure was aggravating, and a surgery urgently needed to be carried out. To solve the severe aortic arch lesions suffered by the baby, the cardiothoracic surgery team led by Director Li Xin, through prudent study and discussion, decided to implement a complete correction of the cardiovascular malformation for the baby. The operation must use the deep hypothermic circulatory technology to completely stop the blood flow in the aorta, and it should be supplemented by selective antegrade cerebral perfusion to reduce the damage to the central nervous system caused by hypoxia during the arrest cycle. Even so, to thoroughly cure this premature baby with such a low weight, the surgeons, anesthesiologists, extracorporeal circulation perfusionists and the postoperative care medical team face significant challenges. The operation lasted for 8 hours, the aortic arch reconstruction was very satisfactory, and the extracorporeal circulation was threatening but not dangerous. After the operation, the baby was transferred to the intensive care unit. On the 4th day after the operation, the baby was able breathe without the assistance of the ventilator, and was returned to his parents in a few days.

This is the cardiopulmonary bypass surgery performed by our hospital on a patient with the lowest weight. The success of the operation reflects the comprehensive strength of the cardiothoracic surgery team and the overall level of our hospital. In recent years, our hospital has cooperated in conducting the early screening of neonatal congenital heart diseases among babies in Jiangsu Province and Suzhou City, establishing “green channel” for consultation and referral with many cooperative units in the province and the city. Equipped with advanced transfer beds, ventilators and various first-aid devices, the neonatal transfer vehicle in our hospital is escorted by experienced neonatal specialists, ensuring the safe transfer of critically ill newborn babies and making it possible for them to be transferred to a children’s hospital for treatment. Recently, a number of newborn babies with complicated critical congenital heart disease have been safely transferred to our hospital, where we successfully performed cardiac operations under direct vision, including aortic arch disconnection, complete anomalous pulmonary venous drainage, and transposition of the great arteries. In the current stage, the annual number of neonatal cardiac surgeries conducted in our hospital exceeds 10% of that of all cardiac surgeries, which indicates that the overall strength of our hospital in this field has reached the first-class level in China.