Outcomes following neonatal cardiac surgery in a South African tertiary centre

dc.contributor.advisorZühlke, Liesl
dc.contributor.advisorBrooks, Andre
dc.contributor.authorDu Toit, Derrik
dc.date.accessioned2026-04-23T11:57:55Z
dc.date.available2026-04-23T11:57:55Z
dc.date.issued2023
dc.date.updated2026-04-23T07:30:51Z
dc.description.abstractBackground: Neonatal Cardiac Surgery has developed significantly since its advent, with improved outcomes, survival, and physiological repair. Limited programs offer neonatal cardiac surgery in emerging economies. We report our experience with neonates undergoing cardiac surgery in our cardiac surgery program. Methods: We performed a secondary data analysis on all neonates aged < 30 days undergoing congenital cardiac surgery from 1 April 2017 to 31 March 2020, including outcomes up to 30-days post-surgery. Results: A total of 859 patients underwent cardiac surgery at our center, of these 81 (9.4%) were neonates. The proportion of neonates increased annually (8.7%, 9.6% and 10.2%). There were 49 (60%) males, and 32 (40%) had surgery in the second week of life. Fourteen (17%) were premature, four (5%) had a major chromosomal abnormality, five (6%) a major medical illness and eight (10%) a major non-cardiac structural anomaly. The RACHS categorization of surgery was predominantly RACHS 3; n = 28 (35%) and 4; n = 23 (29%). Hours in ICU were extensive; median 189 [IQR 114-286] as were hours of ventilation; median 95 [IQR 45-163]. Almost 60% (n=48) of procedures were complicated by sepsis, as defined in our database. The in-hospital mortality rate was 13% (n=13); the 30-day mortality rate was 19.8% (n=16). Conclusion: The proportion of neonates in our service increased over the period. Focused strategies to shorten prolonged ICU stay and decrease rates of bacterial sepsis in neonates are needed. A multi-disciplinary, collaborative heart-team approach is crucial for best outcomes.
dc.identifier.apacitationDu Toit, D. (2023). <i>Outcomes following neonatal cardiac surgery in a South African tertiary centre</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/43129en_ZA
dc.identifier.chicagocitationDu Toit, Derrik. <i>"Outcomes following neonatal cardiac surgery in a South African tertiary centre."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2023. http://hdl.handle.net/11427/43129en_ZA
dc.identifier.citationDu Toit, D. 2023. Outcomes following neonatal cardiac surgery in a South African tertiary centre. . University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. http://hdl.handle.net/11427/43129en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Du Toit, Derrik AB - Background: Neonatal Cardiac Surgery has developed significantly since its advent, with improved outcomes, survival, and physiological repair. Limited programs offer neonatal cardiac surgery in emerging economies. We report our experience with neonates undergoing cardiac surgery in our cardiac surgery program. Methods: We performed a secondary data analysis on all neonates aged < 30 days undergoing congenital cardiac surgery from 1 April 2017 to 31 March 2020, including outcomes up to 30-days post-surgery. Results: A total of 859 patients underwent cardiac surgery at our center, of these 81 (9.4%) were neonates. The proportion of neonates increased annually (8.7%, 9.6% and 10.2%). There were 49 (60%) males, and 32 (40%) had surgery in the second week of life. Fourteen (17%) were premature, four (5%) had a major chromosomal abnormality, five (6%) a major medical illness and eight (10%) a major non-cardiac structural anomaly. The RACHS categorization of surgery was predominantly RACHS 3; n = 28 (35%) and 4; n = 23 (29%). Hours in ICU were extensive; median 189 [IQR 114-286] as were hours of ventilation; median 95 [IQR 45-163]. Almost 60% (n=48) of procedures were complicated by sepsis, as defined in our database. The in-hospital mortality rate was 13% (n=13); the 30-day mortality rate was 19.8% (n=16). Conclusion: The proportion of neonates in our service increased over the period. Focused strategies to shorten prolonged ICU stay and decrease rates of bacterial sepsis in neonates are needed. A multi-disciplinary, collaborative heart-team approach is crucial for best outcomes. DA - 2023 DB - OpenUCT DP - University of Cape Town KW - Neonatal Cardiac Surgery KW - cardiac surgery KW - South Africa KW - Child Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2023 T1 - Outcomes following neonatal cardiac surgery in a South African tertiary centre TI - Outcomes following neonatal cardiac surgery in a South African tertiary centre UR - http://hdl.handle.net/11427/43129 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/43129
dc.identifier.vancouvercitationDu Toit D. Outcomes following neonatal cardiac surgery in a South African tertiary centre. []. University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2023 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/43129en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Paediatrics and Child Health
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectNeonatal Cardiac Surgery
dc.subjectcardiac surgery
dc.subjectSouth Africa
dc.subjectChild Health
dc.titleOutcomes following neonatal cardiac surgery in a South African tertiary centre
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMasters
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