Early post-operative outcomes in very young infant patients after off-pump periventricular hybrid surgery vs. on-pump traditional cardiopulmonary bypass

Shukhrat Marassulov 1, Saniya Murzabayeva 1, Rinat Maiorov 1, Assiya Akhmoldaeva 1, Akkerbez Adilbekova 1, Timur Raimkhanov 1, Oleg Lookin 2 *
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1 Department of Pediatric Cardiosurgery, JSC “National Scientific Medical Center”, Astana, Kazakhstan
2 Department of Science, JSC “National Scientific Medical Center”, Astana, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 23, Issue 5, pp. 4-12. https://doi.org/10.23950/jcmk/19617
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Author Contributions: Conceptualization, S. Ma.; methodology, S. Ma., S. Mu., R. M., A. Ak., A. Ad., and T. R.; validation, S. Ma. and S. Mu.; formal analysis, S. Ma., S. Mu., and O. L.; investigation, S. Ma., S. Mu., R. M., A. Ak., A. Ad., T. R., and O. L.; resources, S. Ma.; data curation, S. Ma., S. Mu., and O. L.; writing – original draft preparation, S. Ma., S. Mu. and O. L.; writing – review and editing, S. Ma., S. Mu., R. M., A. Ak., A. Ad., T. R., and O. L.; visualization, O. L.;  supervision, S. Ma.; project administration, S. Ma.; funding acquisition, S. Ma. All authors have read and agreed to the published version of the manuscript.

Data availability statement: The original contributions presented in this study are included in the article. Further inquiries can be directed to the corresponding author.

Artificial Intelligence (AI) Disclosure Statement: The authors declare no AI Tools used for preparation of this work.

Informed Consent Statement: As the study contains fully depersonalized data and is retrospective by design, we did not obtain informed consent from the patients (their parents) to disseminate obtained results.

ABSTRACT

Background: Traditionally ventricular septal defects (VSDs) are corrected via open-heart surgery under cardiopulmonary bypass (CPB), which involves prolonged anesthesia and increases the risk of neurological complications in very young children. In the present retrospective study, we compare early post-operative outcomes of traditional CPB versus a periventricular hybrid surgery (PHS) for VSD correction in infants aged ≤1 year. Methods: The patients were divided into the PHS cohort (n=181) and the CPB cohort (n=189), treated between 2016 and 2024 at a single center. Results: The hybrid approach significantly reduced the duration of anesthesia, mechanical ventilation, intensive care unit (ICU) stay, and in-hospital stay. The post-operative left ventricular ejection fraction (LVEF) was significantly higher while its change vs. pre-operative level was significantly lower in the PHS vs. CPB cohort. Only 21% of PHS patients required inotropic support, compared to 95.8% of CPB patients. Notably, the CPB cohort exhibited a significantly higher incidence of early post-operative transient neurological disorders vs. the PHS cohort (46.0% vs. 8.3%). We identified age as well as weight, height, and body surface area as risk factors for neurological complications in both surgical cohorts, regardless the type of a neurological complication. Additionally, we revealed lowered intraoperative arterial pressure and elevated post-operative LVEF as independent risk factors. Conclusions: The hybrid VSD correction is a highly effective and safer alternative to traditional open-heart surgery for infants. It significantly minimizes early post-operative morbidities, reduces recovery times, and dramatically lowers the incidence of transient brain ischemia that can result in various neurological disorders.
Keywords: congenital heart defect, ventricular septal defect, infant patients, open-heart surgery, hybrid surgery, early post-operative complications, neurological disorders

CITATION

Marassulov S, Murzabayeva S, Maiorov R, Akhmoldaeva A, Adilbekova A, Raimkhanov T, et al. Early post-operative outcomes in very young infant patients after off-pump periventricular hybrid surgery vs. on-pump traditional cardiopulmonary bypass. J CLIN MED KAZ. 2026;23(5):4-12. https://doi.org/10.23950/jcmk/19617

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