The advances in neonatal care and pediatric cardiac surgery have allowed
repairing of complex congenital heart disease in the newborn and young infants with
excellent results. The most common congenital heart defects that may need early
surgical treatment are tetralogy of Fallot (TOF), transposition of the great arteries
(TGA), univentricular heart, total anomalous pulmonary veins connection, hypoplastic
left heart syndrome, critical aortic stenosis, and truncus arteriosus. TGA, characterized
by atrioventricular concordance with ventriculoarterial discordance, is the most
common cyanogenic cardiopathy, which requires treatment in the neonatal period.
Atrioseptostomy with Raskind balloon must be performed in the newborn with TGA,
who presents significant hypoxia and restrictive atrial septal defect. Surgical treatment
of TGA depends on the gestational age diagnosis, associated defects and evaluation of
the left ventricle anatomy and function. TOF is the cyanogenic cardiopathy that
requires therapy more frequently within the first year of life. Those newborns with
TOF who present severe cyanoses and or hypoxic crises may become ductus
dependent, requiring surgical shunting procedure, percutaneous ductal stenting or total
repair. Currently, there is a trend to perform neonatal total surgical repair in the centers
of excellence, based in the low surgical risk. In univentricular hearts, medical decision
depends on some anatomical aspects. While in case of significant pulmonary flow
obstruction, it will require shunting procedure, in case of pulmonary overflow, it may
need pulmonary banding. Total anomalous pulmonary venous return, critical aortic
valve stenosis, and pulmonary atresia patients will require surgical or interventional
heart catheterization procedures as a newborn. While, newborns with Ebstein’s
anomaly have about 60% chance of requiring early surgical intervention.
Keywords: Ballon atrioseptostomy, Congenital heart disease, Neonatal cardiac
surgery.
