{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T04:54:32Z","timestamp":1784782472496,"version":"3.55.0"},"reference-count":50,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,8,1]]},"abstract":"<jats:p>Objective. Success in treatment of premature infants has resulted in increased numbers of neonates who have bronchopulmonary dysplasia (BPD) and require surgical palliation or repair of congenital heart disease (CHD). We sought to investigate the impact of BPD on children with CHD after heart surgery.<\/jats:p><jats:p>Methods. This was a retrospective, multicenter study of patients who had BPD, defined as being oxygen dependent at 28 days of age with radiographic changes, and CHD and had cardiac surgery (excluding arterial duct ligation) between January 1991 and January 2002. Forty-three infants underwent a total of 52 cardiac operations. The median gestational age at birth was 28 weeks (range: 23\u201335 weeks), birth weight was 1460 g (range: 431\u20132500 g), and age at surgery was 2.7 months (range: 1.0\u201311.6 months). Diagnoses included left-to-right shunts (n = 15), conotruncal abnormalities (n = 13), arch obstruction (n = 6), univentricular hearts (n = 4), semilunar valve obstruction (n = 3), Shone syndrome (n = 1), and cor triatriatum (n = 1).<\/jats:p><jats:p>Results. Thirty-day survival was 84% with 6 early and 6 late postoperative deaths. Survival to hospital discharge was 68%. There was 50% mortality for patients with univentricular hearts and severe BPD. The median duration of preoperative ventilation was 76 days (range: 2\u2013244 days) and of postoperative ventilation was 15 days (range: 1\u2013141 days). The median duration of cardiac ICU stay was 7.5 days (range: 1\u201330 days) and of hospital stay was 115 days (range: 35\u2013475 days). Current pulmonary status includes on room air (n = 14), O2 at home (n = 4), and ventilated at home (n = 4) or in hospital (n = 4), and 5 patients were lost to follow-up.<\/jats:p><jats:p>Conclusions. BPD has significant implications for children who have CHD and undergo cardiac surgery, leading to prolonged ICU and hospital stays, although most survivors are not O2 dependent. Postoperative mortality was highest among patients with univentricular hearts and severe BPD. Optimal timing of surgery and strategies to improve outcome remains to be delineated.<\/jats:p>","DOI":"10.1542\/peds.2004-2168","type":"journal-article","created":{"date-parts":[[2005,8,2]],"date-time":"2005-08-02T14:55:38Z","timestamp":1122994538000},"page":"423-430","source":"Crossref","is-referenced-by-count":37,"title":["Preterm Infants With Congenital Heart Disease and Bronchopulmonary Dysplasia: Postoperative Course and Outcome After Cardiac Surgery"],"prefix":"10.1542","volume":"116","author":[{"given":"Colin J.","family":"McMahon","sequence":"first","affiliation":[{"name":"Divisions of Pediatric Cardiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Penny","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Royal Children's Hospital, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Cincinnati Children's Hospital, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Ades","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salim","family":"Al Maskary","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Royal Children's Hospital, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Speer","sequence":"additional","affiliation":[{"name":"Neonatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Katkin","sequence":"additional","affiliation":[{"name":"Pulmonology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Dean","family":"McKenzie","sequence":"additional","affiliation":[{"name":"Congenital Heart Surgery, Texas Children's Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr, MD","given":"Charles D.","family":"Fraser","sequence":"additional","affiliation":[{"name":"Congenital Heart Surgery, Texas Children's Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony C.","family":"Chang","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Cardiology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2005,8,1]]},"reference":[{"key":"2021121003180797800_R1","doi-asserted-by":"crossref","unstructured":"Northway WH Jr, Rosan RC, Porter DY. Pulmonary disease following respiratory therapy of hyaline membrane disease: bronchopulmonary dysplasia. N Engl J Med.\u20081967;276:357\u2013368","DOI":"10.1056\/NEJM196702162760701"},{"key":"2021121003180797800_R2","unstructured":"Report of the Workshop on Bronchopulmonary Dysplasia. Washington, DC: National Institutes of Health; 1979. NIH Publication No.80\u20131660"},{"key":"2021121003180797800_R3","doi-asserted-by":"crossref","unstructured":"Jobe AH, Bancalari E. Bronchopulmonary dysplasia. HICHD\/NHLBI\/ORD Workshop Summary. Am J Respir Crit Care Med.\u20082001;163:1723\u20131729","DOI":"10.1164\/ajrccm.163.7.2011060"},{"key":"2021121003180797800_R4","doi-asserted-by":"crossref","unstructured":"Horbar JD, Badger GJ, Carpenter JH, et al. Trends in morbidity and mortality for very low birth weight infants, 1991\u20131999. Pediatrics.\u20082002;110:143\u2013151","DOI":"10.1542\/peds.110.1.143"},{"key":"2021121003180797800_R5","unstructured":"National Institute of Child Health and Human Development. Report of the Consensus Development Conference on the Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes. Washington, DC: National Institutes of Health; 1994. NIH Publication No.\u20081994:95\u20133784"},{"key":"2021121003180797800_R6","doi-asserted-by":"crossref","unstructured":"Kennedy JD. Lung function outcome in children of premature birth. J Pediatr Child Health.\u20081999;35:516\u2013521","DOI":"10.1046\/j.1440-1754.1999.00422.x"},{"key":"2021121003180797800_R7","doi-asserted-by":"crossref","unstructured":"Northway WH. BPD. Twenty-five years later. Pediatrics.\u20081992;89:969\u2013973","DOI":"10.1542\/peds.89.5.969"},{"key":"2021121003180797800_R8","doi-asserted-by":"crossref","unstructured":"Farstad T, Brockmeier F, Bratlid D. Cardiopulmonary function in premature infants with bronchopulmonary dysplasia\u2014a 2-year follow-up. Eur J Pediatr.\u20081995;154:853\u2013858","DOI":"10.1007\/BF01959797"},{"key":"2021121003180797800_R9","doi-asserted-by":"crossref","unstructured":"Northway WH. An introduction to bronchopulmonary dysplasia. Clin Perinatol.\u20081992;19:489\u2013495","DOI":"10.1016\/S0095-5108(18)30442-1"},{"key":"2021121003180797800_R10","doi-asserted-by":"crossref","unstructured":"Bard H, Fouron JC, Chessex P, Widness JA. Myocardial, erythropoietic, and metabolic adaptations to anemia of prematurity in infants with bronchopulmonary dysplasia. J Pediatr.\u20081998;132:630\u2013634","DOI":"10.1016\/S0022-3476(98)70351-8"},{"key":"2021121003180797800_R11","doi-asserted-by":"crossref","unstructured":"Baraldi E, Carra S, Vencato F, et al. Home oxygen therapy in infants with bronchopulmonary dysplasia: a prospective study. Eur J Pediatr.\u20081997;156:878\u2013882","DOI":"10.1007\/s004310050735"},{"key":"2021121003180797800_R12","doi-asserted-by":"crossref","unstructured":"Farrell PA, Fiascone JM. Bronchopulmonary dysplasia in the 1990s: a review for the pediatrician. Curr Probl Pediatr.\u20081997;27:133\u2013163","DOI":"10.1016\/S0045-9380(97)80017-5"},{"key":"2021121003180797800_R13","unstructured":"Shekhawat PS, Fang LV, Mitvalsky J, Yu VYH. Spectrum of clinical and cardiac dysfunction in bronchopulmonary dysplasia: early prediction of long-term morbidity. J Perinatol.\u20081997;17:95\u2013100"},{"key":"2021121003180797800_R14","doi-asserted-by":"crossref","unstructured":"Abman SH, Accurso FJ, Bowman CM. Unsuspected cardiopulmonary abnormalities complicating bronchopulmonary dysplasia. Arch Dis Child.\u20081984;59:966\u2013970","DOI":"10.1136\/adc.59.10.966"},{"key":"2021121003180797800_R15","doi-asserted-by":"crossref","unstructured":"Talner NS, Lister G. Perioperative care of the infant with congenital heart disease. Cardiol Clin.\u20081989;7:419\u2013438","DOI":"10.1016\/S0733-8651(18)30446-6"},{"key":"2021121003180797800_R16","doi-asserted-by":"crossref","unstructured":"Chang AC, Hanley FL, Lock JE, Castaneda AR, Wessel DL. Management and outcome of low birth weight neonates with congenital heart disease. J Pediatr.\u20081994;124:461\u2013466","DOI":"10.1016\/S0022-3476(94)70376-0"},{"key":"2021121003180797800_R17","doi-asserted-by":"crossref","unstructured":"Reddy VM. Cardiac surgery for premature and low birth weight neonates. Semin Thorac Cardiovasc Surg Annu.\u20082001;4:271\u2013276","DOI":"10.1053\/pcsu.2001.24985"},{"key":"2021121003180797800_R18","doi-asserted-by":"crossref","unstructured":"Pizarro C, Davis DA, Galantowicz ME, Munro H, Gidding SS, Norwood WI. Stage I palliation for hypoplastic left heart syndrome in low birth weight neonates: can we justify it?Eur J Cardiothorac Surg.\u20082002;21:716\u2013720","DOI":"10.1016\/S1010-7940(02)00073-8"},{"key":"2021121003180797800_R19","doi-asserted-by":"crossref","unstructured":"Wernovsky G, Rubenstein SD, Spray TL. Cardiac surgery in the low-birth weight neonate. New approach. Clin Perinatol.\u20082001;28:249\u2013264","DOI":"10.1016\/S0095-5108(05)70078-6"},{"key":"2021121003180797800_R20","doi-asserted-by":"crossref","unstructured":"Bacha EA, Almodovar M, Wessel DL, et al. Surgery for coarctation of the aorta in infants weighing less than 2kg. Ann Thorac Surg.\u20082001;71:1260\u20131264","DOI":"10.1016\/S0003-4975(00)02664-3"},{"key":"2021121003180797800_R21","doi-asserted-by":"crossref","unstructured":"Numa A, Butt W, Mee R. Outcome of infants with birthweight 2000g or less who undergo major cardiac surgery. J Pediatr Child Health.\u20081992;28:318\u2013320","DOI":"10.1111\/j.1440-1754.1992.tb02676.x"},{"key":"2021121003180797800_R22","doi-asserted-by":"crossref","unstructured":"Pawade A, Waterson K, Laussen P, Karl TR, Mee RB. Cardiopulmonary bypass in neonates less than 2.5kg: analysis of the risk factors for early and late mortality. J Cardiac Surg.\u20081993;8:1\u20138","DOI":"10.1111\/j.1540-8191.1993.tb00570.x"},{"key":"2021121003180797800_R23","unstructured":"Bohn D. Cardiopulmonary interactions. In: Chang AC, Hanley FL, Wernovsky G, Wessel DL, eds. Pediatric Cardiac Intensive Care. Baltimore, MD: Lippincott Williams & Wilkins; 1998:107\u2013125"},{"key":"2021121003180797800_R24","doi-asserted-by":"crossref","unstructured":"Pessonen EJ, Korpela R, Peltola K, et al. Regional generation of free oxygen radicals during cardiopulmonary bypass in children. J Thorac Cardiovasc Surg.\u20081995;110:768\u2013773","DOI":"10.1016\/S0022-5223(95)70110-9"},{"key":"2021121003180797800_R25","unstructured":"Newth JL, Hammer J. Pulmonary issues. In: Chang AC, Hanley FL, Wernovsky G, Wessel DL, eds. Pediatric Cardiac Intensive Care. Baltimore, MD: Lippincott Williams & Wilkins; 1998:351\u2013367"},{"key":"2021121003180797800_R26","doi-asserted-by":"crossref","unstructured":"Rabinovitch M, Grady S, David I, et al. Compression of intra-pulmonary bronchi by abnormally branching pulmonary arteries associated with absent pulmonary valves. Am J Cardiol.\u20081982;50:804\u2013813","DOI":"10.1016\/0002-9149(82)91238-3"},{"key":"2021121003180797800_R27","unstructured":"Lister G, Talner NS. Management of respiratory failure of cardiac origin. In: Gregory G, ed. Clinics in Critical Care Medicine: Respiratory Failure in the Child. New York, NY: Churchill Livingstone; 1981:67\u201388"},{"key":"2021121003180797800_R28","doi-asserted-by":"crossref","unstructured":"Schulze-Neick I, Ho SY, Bush A, et al. Severe airflow limitation after the unifocalization procedure: clinical and morphological correlates. Circulation.\u20082000;102:III142\u2013III147","DOI":"10.1161\/01.CIR.102.suppl_3.III-142"},{"key":"2021121003180797800_R29","doi-asserted-by":"crossref","unstructured":"Gorenflo M, Vogel M, Obladen M. Pulmonary vascular changes in bronchopulmonary dysplasia: a clinicopathologic correlation in short- and long-term survivors. Pediatr Pathol.\u20081991;11:851\u2013866","DOI":"10.3109\/15513819109065482"},{"key":"2021121003180797800_R30","doi-asserted-by":"crossref","unstructured":"Bland RD, Albertine KH, Carlton DP, et al. Chronic lung injury in preterm lambs: abnormalities of the pulmonary circulation and lung fluid balance. Pediatr Res.\u20082000;48:64\u201374","DOI":"10.1203\/00006450-200007000-00013"},{"key":"2021121003180797800_R31","doi-asserted-by":"crossref","unstructured":"Parker TA, Abman SH. The pulmonary circulation in bronchopulmonary dysplasia. Semin Neonatol.\u20082003;8:51\u201361","DOI":"10.1016\/S1084-2756(02)00191-4"},{"key":"2021121003180797800_R32","doi-asserted-by":"crossref","unstructured":"Bush A, Busst CM, Knight WB, Hislop AA, Haworth SG, Shinebourne EA. Changes in pulmonary circulation in severe bronchopulmonary dysplasia. Arch Dis Child.\u20081990;65:739\u2013745","DOI":"10.1136\/adc.65.7.739"},{"key":"2021121003180797800_R33","doi-asserted-by":"crossref","unstructured":"Doull IJ, Mok Q, Tasker RC. Tracheobronchomalacia in preterm infants with chronic lung disease. Arch Dis Child Fetal Neonatal Ed.\u20081997;76:F203\u2013F205","DOI":"10.1136\/fn.76.3.F203"},{"key":"2021121003180797800_R34","doi-asserted-by":"crossref","unstructured":"Karl TR, Sano S, Horton S, et al. Centrifugal pump left heart assist in pediatric cardiac operations. Indications, techniques, and results. J Thorac Cardiovasc Surg.\u20081991;102:624\u2013630","DOI":"10.1016\/S0022-5223(20)31437-9"},{"key":"2021121003180797800_R35","unstructured":"Kulik TJ, Moler FW, Palnisano JM, et al. Outcome associated factors in pediatric patients treated with extracorporeal membrane oxygenator after cardiac surgery. Circulation.\u20081996;94:II63\u2013II68"},{"key":"2021121003180797800_R36","unstructured":"del Nido PJ, Armitaje JM, Fricker FJ, et al. Extracorporeal membrane oxygenation as a bridge to transplantation in pediatric heart transplantation. Circulation.\u20081994;90:II66\u2013II69"},{"key":"2021121003180797800_R37","doi-asserted-by":"crossref","unstructured":"Feltes TF, Cavalka AK, Meissner HC, et al. Cardiac Synagis Study Group. Palivizumab prophylaxis reduces hospitalization due to respiratory syncytial virus in young children with hemodynamically significant congenital heart disease. J Pediatr.\u20082003;143:532\u2013540","DOI":"10.1067\/S0022-3476(03)00454-2"},{"key":"2021121003180797800_R38","doi-asserted-by":"crossref","unstructured":"Hadfield PJ, Lloyd-Faulconbridge RV, Almeyda J, Albert DM, Bailey CM. The changing indications for pediatric tracheostomy. Int J Pediatr Otorhinolaryngol.\u20082003;67:7\u201310","DOI":"10.1016\/S0165-5876(02)00282-3"},{"key":"2021121003180797800_R39","doi-asserted-by":"crossref","unstructured":"Coates AL, Blanchard PW, Vachon F, Schloss MD. Simplified oxygen administration in tracheostomized patients with bronchopulmonary dysplasia. Int J Pediatr Otorhinolaryngol.\u20081985;10:87\u201390","DOI":"10.1016\/S0165-5876(85)80061-6"},{"key":"2021121003180797800_R40","doi-asserted-by":"crossref","unstructured":"Brion LP, Primhak RA. Intravenous or enteral loop diuretics for preterm infants with (or developing) chronic lung disease. Cochrane Database Syst Rev.\u20082000;(4):CD001453","DOI":"10.1002\/14651858.CD001453"},{"key":"2021121003180797800_R41","doi-asserted-by":"crossref","unstructured":"Pai VB, Nahat MC. Aerosolized furosemide in the treatment of acute respiratory distress and possible bronchopulmonary dysplasia in preterm neonates. Ann Pharmacother.\u20082000;34:386\u2013392","DOI":"10.1345\/aph.19060"},{"key":"2021121003180797800_R42","doi-asserted-by":"crossref","unstructured":"Kao LC, Durand DJ, McCrea RC, Birch M, Powers RJ, Nickerson BG. Randomized trial of long-term diuretic therapy for infants with oxygen-dependent bronchopulmonary dysplasia. J Pediatr.\u20081994;124:772\u2013781","DOI":"10.1016\/S0022-3476(05)81373-3"},{"key":"2021121003180797800_R43","doi-asserted-by":"crossref","unstructured":"van der Kuip M, Hoos MB, Forget PP, et al. Energy expenditure in infants with congenital heart disease, including a meta-analysis. Acta Paediatr.\u20082003;92:921\u2013927","DOI":"10.1111\/j.1651-2227.2003.tb00625.x"},{"key":"2021121003180797800_R44","doi-asserted-by":"crossref","unstructured":"McElhinney DB, Hedrick HL, Bush DM, et al. Necrotizing enterocolitis in neonates with congenital heart disease: risk factors and outcomes. Pediatrics.\u20082000;106:1080\u20131087","DOI":"10.1542\/peds.106.5.1080"},{"key":"2021121003180797800_R45","doi-asserted-by":"crossref","unstructured":"Newth CJ, Gow RM, Rowe RD. The assessment of pulmonary arterial pressures in bronchopulmonary dysplasia by cardiac catheterization and M-mode echocardiography. Pediatr Pulmonol.\u20081985;1:58\u201362","DOI":"10.1002\/ppul.1950010113"},{"key":"2021121003180797800_R46","doi-asserted-by":"crossref","unstructured":"McMahon CJ, Price JF, Salerno JC, et al. Cardiac catheterization in infants weighing less than 2500 grams. Cardiol Young.\u20082003;13:117\u2013122","DOI":"10.1017\/S1047951103000246"},{"key":"2021121003180797800_R47","doi-asserted-by":"crossref","unstructured":"Banks BA, Seri I, Ischiropoulos H, et al. Changes in oxygenation with inhaled nitric oxide in severe bronchopulmonary dysplasia. Pediatrics.\u20081999;103:610\u2013618","DOI":"10.1542\/peds.103.3.610"},{"key":"2021121003180797800_R48","doi-asserted-by":"crossref","unstructured":"Michelakis ED, Tymchak W, Noga M, et al. Long-term treatment with oral sildenafil is safe and improves functional capacity and hemodynamics in patients with pulmonary arterial hypertension. Circulation.\u20082003;108:2066\u20132069","DOI":"10.1161\/01.CIR.0000099502.17776.C2"},{"key":"2021121003180797800_R49","unstructured":"Chang AC, Hanley FL, Wernovsky G, et al. Early bi-directional cavopulmonary shunt in young infants. Postoperative course and early results. Circulation.\u20081993;88:II149\u2013158"},{"key":"2021121003180797800_R50","doi-asserted-by":"crossref","unstructured":"Allen SW, Gauvreau K, Bloom BT, Jenkins KJ. Evidence-based referral results in significantly reduced mortality after congenital heart surgery. Pediatrics.\u20082003;112:24\u201328","DOI":"10.1542\/peds.112.1.24"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/116\/2\/423\/1004710\/zpe00805000423.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/116\/2\/423\/1004710\/zpe00805000423.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T23:35:58Z","timestamp":1683156958000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/116\/2\/423\/62896\/Preterm-Infants-With-Congenital-Heart-Disease-and"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,8,1]]},"references-count":50,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2005,8,1]]},"published-print":{"date-parts":[[2005,8,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2004-2168","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,8,1]]}}}