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Neonatal Outcomes of Critical Congenital Heart Defects: A Multicenter Epidemiological Study of Turkish Neonatal Society

Neonatal Outcomes of CCHD

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Abstract

Critical congenital heart disease (CCHD) is one of the leading causes of neonatal and infant mortality. We aimed to elucidate the epidemiology, spectrum, and outcome of neonatal CCHD in Türkiye. This was a multicenter epidemiological study of neonates with CCHD conducted from October 2021 to November 2022 at national tertiary health centers. Data from 488 neonatal CCHD patients from nine centers were entered into the Trials-Network online registry system during the study period. Transposition of great arteria was the most common neonatal CHD, accounting for 19.5% of all cases. Sixty-three (12.9%) patients had extra-cardiac congenital anomalies. A total of 325 patients underwent cardiac surgery. Aortic arch repair (29.5%), arterial switch (25.5%), and modified Blalock–Taussig shunt (13.2%). Overall, in-hospital mortality was 20.1% with postoperative mortality of 19.6%. Multivariate analysis showed that the need of prostaglandin E1 before intervention, higher VIS (> 17.5), the presence of major postoperative complications, and the need for early postoperative extracorporeal membrane oxygenation were the main risk factors for mortality. The mortality rate of CCHD in our country remains high, although it varies by health center. Further research needs to be conducted to determine long-term outcomes for this vulnerable population.

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Data Availability

The data that support the findings of this study are available on request from the corresponding author (DD).

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Funding

This study was supported by the Turkish Neonatal Society (TNS), which funded the online registration system used by the study (https://www.trials-network.org/). The TNS had no role in the study design, data analysis, decision to publish, or preparation of the article. The corresponding author had full access to all the data in the study and took final responsibility for the decision to submit the manuscript for publication. The final version of the manuscript was approved by all authors. No honorarium, grant, or other form of funding was provided to any author in connection with the study.

Author information

Authors and Affiliations

  1. Department of Neonatology, Dr. Sami Ulus Research and Application Center, Health Science University of Turkey, Ankara, Turkey

    Dilek Dilli, Hasan Akduman & Ayşegül Zenciroğlu

  2. Department of Neonatology, Başakşehir Çam Sakura City Hospital, Health Science University of Turkey, İstanbul, Turkey

    Merih Çetinkaya

  3. Department of Neonatology, Gazi Yaşargil Research and Application Center, Health Science University of Turkey, Diyarbakır, Turkey

    Nilüfer Okur

  4. Department of Neonatology, Başkent University, Medical Faculty, Ankara, Turkey

    Özden Turan

  5. Department of Neonatology, Çukurova University, Medical Faculty, Adana, Turkey

    Ferda Özlü

  6. Department of Neonatology, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Health Science University of Turkey, İzmir, Turkey

    Şebnem Çalkavur

  7. Department of Neonatology, İstanbul Medipol University, International Faculty of Medicine, Istanbul, Turkey

    Gamze Demirel

  8. Department of Neonatology, Uludağ University, Medical Faculty, Bursa, Turkey

    Nilgün Koksal

  9. Department of Neonatology, Beykent University Medical Faculty, Istanbul, Turkey

    Rüya Çolak

  10. Department of Pediatric Cardiology, Dr. Sami Ulus Research and Application Center, Health Science University of Turkey, Ankara, Turkey

    Utku Arman Örün

  11. Department of Pediatric Cardiology, Başakşehir Çam Sakura City Hospital, Health Science University of Turkey, Istanbul, Turkey

    Erkut Öztürk

  12. Department of Pediatric Cardiology, Gazi Yaşargil Research and Application Center, Health Science University of Turkey, Diyarbakır, Turkey

    Özlem Gül

  13. Department of Pediatric Cardiology, Başkent University, Medical Faculty, Ankara, Turkey

    Niyazi Kürşad Tokel

  14. Department of Pediatric Cardiology, Çukurova University, Medical Faculty, Adana, Turkey

    Sevcan Erdem

  15. Department of Pediatric Cardiology, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Health Science University of Turkey, İzmir, Turkey

    Timur Meşe

  16. Department of Pediatric Cardiology, İstanbul Medipol University, International Faculty of Medicine, İstanbul, Turkey

    Abdullah Erdem

  17. Department of Pediatric Cardiology, Uludağ University, Medical Faculty, Bursa, Turkey

    Özlem Mehtap Bostan

  18. Department of Pediatric Cardiology, Beykent University, Medical Faculty, İstanbul, Turkey

    Tuğçin Bora Polat

  19. Department of Pediatric Cardiovascular Surgery, Dr. Sami Ulus Research and Application Center, Health Science University of Turkey, Ankara, Turkey

    Mehmet Taşar

  20. Department of Pediatric Cardiovascular Surgery, Başakşehir Çam Sakura City Hospital, Health Science University of Turkey, İstanbul, Turkey

    Ali Can Hatemi

  21. Department of Pediatric Cardiovascular Surgery, Gazi Yaşargil Research and Application Center, Health Science University of Turkey, Diyarbakır, Turkey

    Onur Doyurgan

  22. Department of Pediatric Cardiovascular Surgery, Başkent University, Medical Faculty, Ankara, Turkey

    Murat Özkan

  23. Department of Pediatric Cardiovascular Surgery, Çukurova University, Medical Faculty, Adana, Turkey

    Mustafa Kemal Avşar

  24. Department of Pediatric Cardiovascular Surgery, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Health Science University of Turkey, İzmir, Turkey

    Osman Nejat Sarıosmanoğlu

  25. Department of Pediatric Cardiovascular Surgery, İstanbul Medipol University, International Faculty of Medicine, İstanbul, Turkey

    Murat Uğurlucan

  26. Department of Pediatric Cardiovascular Surgery, Uludağ University, Medical Faculty, Bursa, Turkey

    Işık Şenkaya Sığnak

  27. Department of Pediatric Cardiovascular Surgery, Beykent University, Medical Faculty, Istanbul, Turkey

    Murat Başaran

Authors
  1. Dilek Dilli
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  2. Hasan Akduman
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  3. Ayşegül Zenciroğlu
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  4. Merih Çetinkaya
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  5. Nilüfer Okur
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  6. Özden Turan
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  8. Şebnem Çalkavur
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  9. Gamze Demirel
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  10. Nilgün Koksal
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  13. Erkut Öztürk
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  14. Özlem Gül
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  15. Niyazi Kürşad Tokel
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  16. Sevcan Erdem
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  17. Timur Meşe
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  18. Abdullah Erdem
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  19. Özlem Mehtap Bostan
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  20. Tuğçin Bora Polat
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  21. Mehmet Taşar
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  22. Ali Can Hatemi
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  23. Onur Doyurgan
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  24. Murat Özkan
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  25. Mustafa Kemal Avşar
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  26. Osman Nejat Sarıosmanoğlu
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  27. Murat Uğurlucan
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  28. Işık Şenkaya Sığnak
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  29. Murat Başaran
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Contributions

Contribution to study concept: DD, HA, UAÖ, and MT, Design: DD, HA, UAÖ, and AZ, Acquisition of data: All authors, Analysis: DD and HA, Interpretation of data: DD, Revising the manuscript: All authors.

Corresponding author

Correspondence to Dilek Dilli.

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Conflict of interest

The authors have no competing interests to disclose.

Ethical Approval

This study was approved by the Institutional Review Board of the TNS Multicenter Research Scientific Steering Committee (E-21/04-162, date: April 7, 2021). Verbal and written informed consent were obtained from the parents of the newborns.

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Dilli, D., Akduman, H., Zenciroğlu, A. et al. Neonatal Outcomes of Critical Congenital Heart Defects: A Multicenter Epidemiological Study of Turkish Neonatal Society. Pediatr Cardiol 45, 257–271 (2024). https://doi.org/10.1007/s00246-023-03362-z

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