• Hui Luo, Gang Qin, Lu Wang, Zhi Ye, Yundan Pan, Lingjin Huang, Wanjun Luo, Qulian Guo, Yonggang Peng, and E Wang.
• Department of Anesthesiology, Xiangya Hospital Central South University, Changsha, Hunan, China.
• J. Cardiothorac. Vasc. Anesth. 2019 Feb 1; 33 (2): 428-432.

ObjectivesThere is still controversy about whether an infant should have cardiac surgery concomitant with ongoing persistent pneumonia. This study analyzes the outcome of surgical treatment for infants with left-to-right shunt congenital heart disease accompanied with persistent pneumonia and discusses the perioperative management strategies for these cases.DesignThis is a retrospective cohort study.SettingThis study was conducted in an academic hospital and is a single-center study.ParticipantsIn this study, the authors analyzed the data of 94 infants admitted to our hospital from January 2014 to May 2016 who underwent surgical correction for left-to-right shunt congenital heart disease.InterventionsFifty cases without pneumonia were included as a control group, and 44 cases with unresolved persistent pneumonia were included as a study group. The clinical characteristics between the 2 groups were compared, and the perioperative safety and short-term prognosis were evaluated.Measurements And Main ResultsThere was no significant difference in sex composition between the 2 groups. Infants in the pneumonia group were younger and had a lower body weight (p < 0.001). There was a significant difference in types of congenital heart disease between the 2 groups (p < 0.001). Preoperative body temperature and heart rate of infants in the pneumonia group were higher than those in the control group (p < 0.001). The cardiopulmonary bypass time in the pneumonia group was significantly longer than that of the control group (p = 0.001). Perioperative major complications were not significantly different between the 2 groups. The postoperative ventilator-assisted time, duration of intensive care unit stay, and length of hospital stay were longer in the pneumonia group (p < 0.001). Only 1 patient in the control group died of severe low cardiac output syndrome.ConclusionThe authors conclude that in the presented cases, no mortality or major morbidity was observed related to the practice of performing surgery in infants with signs of persistent pneumonia. The authors conclude that it is likely to be safe and effective for infants to receive cardiac surgery for left-to-right shunt congenital heart disease in the presence of persistent pneumonia.Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

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