Outcomes of Perioperative Mortality and Neurodevelopment in Infants with CHD

Overview

This study evaluates the impact of perioperative ECMO on mortality and neurodevelopmental outcomes in infants under six weeks undergoing cardiac surgery. Findings indicate a 5.8% mortality rate, with ECMO associated with significantly higher mortality.

Background

Complex congenital heart disease (CHD) and neonatal cardiac surgery are associated with increased risks of mortality and neurodevelopmental impairment. The use of extracorporeal membrane oxygenation (ECMO) in this population raises concerns regarding its impact on long-term outcomes.

Data Highlights

Key Findings

• The overall 1-year mortality rate was 5.8% among 240 patients.
• Perioperative ECMO was utilized in 14.2% of patients, with a mortality rate of 29.4% in this group.
• Univentricular CHD was more frequently associated with higher mortality in the ECMO group (p = 0.005).
• Both cognitive and motor composite scores were significantly lower in the ECMO group compared to the non-ECMO group (p < 0.001).
• Longer hospital stays and lower socioeconomic status were associated with lower motor composite scores.

Clinical Implications

Clinicians should be aware of the increased mortality associated with the use of ECMO in infants undergoing cardiac surgery.

Conclusion

The study highlights the significant risks associated with perioperative ECMO in infants with CHD.

Related Resources & Content

1. Frontiers in Pediatrics, 2026 -- Outcomes after extracorporeal membrane oxygenation following cardiac surgery
2. Pediatric Cardiology, 2010 -- Factors Influencing Outcomes in Pediatric Extracorporeal Cardiopulmonary Resuscitation
3. Pediatric Cardiology, 2021 -- Effects of Prematurity on Health Outcomes and Survival Rates in Newborns Diagnosed with Dextro-transposition of the Great Arteries
4. Frontiers in Pediatrics — Two-year neurodevelopmental outcome in preterm neonates with cerebral oxygenation monitoring after birth: a multinational, multicenter retrospective follow-up study of the COSGOD III trial
5. Intensive Care Medicine — Neuropsychological Outcomes in Pediatric and Adolescent Survivors of Cardiac Arrest: A Long-Term Perspective
6. Frontiers | Perioperative mortality and one-year neurodevelopmental outcome after cardiac surgery prior to six weeks of age requiring perioperative extracorporeal membrane oxygenation in the first year of life
7. Outcomes after extracorporeal membrane oxygenation following the norwood procedure: a systematic review and meta-analysis | Journal of Cardiothoracic Surgery | Springer Nature Link
8. Part 5: Neonatal Resuscitation: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care | Pediatrics | American Academy of Pediatrics