1. Author: Denisa Pop 1 Second Authors: Dominic Pascal Keller 1 Roxana Costache 1 Tamas Szabo 1 Coordinators: Medical Doctor Valentin Stroe 2 Professor Horatiu Suciu 2 1 2 Marisiensis 2015

2. The congenital heart defects are present in the neonatal period  Critical congenital heart diseases dependent on a PDA  Require intervention within the first month  Neonatal arrhythmias EMERGENCY

3. Pediatric Cardiovascular Center Pediatric Cardiology Pediatric Cardiovascular Surgery Pediatric Surgical ICU Operating UnitAngio-Cath Lab Neonatology Department SMURD Discharge Admission IuBCVT

4. The activity of IuBCVT Tîrgu-Mureş the single-center in Romania for the surgical treatment of neonatal emergencies

5. IuBCVT Tîrgu-Mureş 136 patients 54 female 82 male The inclusion criteria:  Urgency of surgery  Diagnostics  Age

6. 8 44 49 35 Distribution of patients AGE DIAGNOSTICS The mean age at the time of surgery- 17.80 days

7. Transposition of Great Arteries (TGA) TGA is a congenital cyanotic heart defect The Aorta and the Pulmonary Artery reversed

8. TGA - 2 parallel circulations RA RV Aorta Systemic circulation Pulmonary Circulation Pulmonary Artery LA LV ASD VSD PDA

9. Management and treatment of TGA prostaglandin E1 IV  PDA open  ↑ pulmonary flow atrial balloon septostomy  ↑ ASD  improve the mixing stabilization of the patient  1. Immediate

10. 2. Definitive arterial switch operation

11. Mortality Transposition of the Great Arteries associated with: Interrupted Aortic Arch Subpulmonary VSD and ASD Severe Hypoxia and Acidosis 136 patients 3 intraoperative deaths  DIAGNOSTIC

12. Conclusion High survival rate (97.80% for our patients) Early diagnostic -within hours- Adequate surgical approach -first month of life- In all these cases, the surgical treatment must be rushed in order to prevent major morbidity and mortality and minimize the need of future surgeries.

13. Discussions IuBCVT Tîrgu-Mure the single-center for the surgical treatment of neonatal emergencies high difficulty of creating national interdisciplinary teams to deal with this emergencies

14. Bibliography Illustrations provided by Joe Lara III for www. pediatricheartspecialists.com Constantine Mavroudis and Carl L. Backer. Pediatric Cardiac Surgery Fourth Edition, John Wiley & Sons Ltd. Publication 2013. 26-492 Transposition of the Great Arteries. www.nlm.nih.gov/medlineplus, Bethesda (MD): National Library of Medicine (US), updated 2013 May 11 by Kurt R. Schumacher, MD, Pediatric Cardiology, University of Michigan Congenital Heart Center, Ann Arbor, MI.

15. Thank you for your attention!