With advances in medicine, the timing of surgery for congenital heart disease cannot be determined by age or tolerance of surgery. In general, congenital heart disease rarely recovers spontaneously, and most of them should be treated with surgery early. In some cases, the complications increase with age and the condition gets progressively worse. Even if there are no symptoms, do not hesitate. If left untreated, some complications are endocarditis, embolism, bleeding, hypertension and life-threatening. Therefore, the best time for surgery for precordial disease should be based on the specific condition of the child. Dong Nianguo, Department of Cardiac Surgery, Wuhan Union Hospital
The timing of surgery for the most common congenital heart diseases, such as ventricular septal defect, atrial septal defect, and patent ductus arteriosus, depends on the size of the defect. If the defect is large, the fractional flow is large, pulmonary congestion is severe, often accompanied by complications such as heart failure and pneumonia, and pulmonary hypertension is severe, early surgery should be performed, and the surgery can be performed in infancy (within 1 year) or even during the neonatal period.
For cyanotic preconditioning, such as tetralogy of Fallot and pulmonary atresia, if there is severe hypoxia, surgery should also be performed in infancy (within 1 year of age), and for children who do not qualify for radical treatment, palliative surgery should be performed first to save life. For severe cardiovascular malformations, such as complete transposition of the great arteries combined with pulmonary hypertension, complete ectopic drainage of the pulmonary veins, common arterial trunk, interruption of the aortic arch and other rare and complex malformations, surgery should be sought as early as possible (it can be performed within hours after birth).
Our cardiovascular surgery department can perform surgical treatment of complex congenital heart disease in newborns and small infants, regardless of age and weight, with nearly 600 surgeries in infants and children each year.