Objective: To describe surgical outcomes, in-hospital mortality, and variables associated with mortality in pediatric patients with congenital heart disease (CHD) at a national referral center in México over 14 years. Methodology: Retrospective cross-sectional study of 4494 patients under 18 years of age with CHD undergoing cardiac surgery (2010-2024) at the Instituto Nacional de Cardiología “Ignacio Chávez,” using Registro Nacional de Cirugía Cardíaca Pediátrica y Cardiopatías Congénitas (RENACCAPE) data. Comparisons used χ 2 , Fisher's exact, and Mann–Whitney U tests ( P < .05). Analysis was univariate; RACHS-1/STAT scores were incompletely recorded and excluded from risk adjustment. Results: Among 4494 patients (53.5% 2405/4494 male), the predominant age groups were children 1 to 12 years (56.1% 2521/4494), infants 1 to 11 months (19.8% 888/4494), adolescents (17.4% 784/4494), and neonates (6.7% 301/4494). Down syndrome (6.2% 277/4494) and DiGeorge syndrome (1.2% 55/4494) were the most frequent genetic comorbidities; 85.5% (3844/4494) underwent elective surgery. Leading procedures included ventricular septal defect closure (13.6%; 611/4494 mortality 1.8% 11/611), modified Blalock–Taussig-Thomas shunt (9.8% 440/4494; mortality 11.1% 49/440), total anomalous pulmonary venous connection repair (7.4% 334/4494; mortality 8.4% 28/334), atrial septal defect closure (6.7% 303/4494; mortality 0.0%), and tetralogy of Fallot repair (5.9% 267/4494; mortality 7.9% 21/267). Norwood had the highest procedure-specific mortality (71.4% 5/7), followed by Damus–Kaye–Stansel (60.0%) and Jatene (26.0% 32/123). Overall mortality was 9.4% (421/4494), declining from 10.5% (2010) to 7.1% (2024), with a transient rise during COVID-19. Mortality-associated variables included neonatal/infant age, low weight, cyanotic CHD, genetic syndromes, prolonged cardiopulmonary bypass (147 vs 89 min), longer aortic cross-clamp time (83 vs 54 min), and urgent surgery (all P < .001). Conclusions: To our knowledge this is this largest single-center Mexican pediatric CHD series, in-hospital mortality was 9.4% with a declining trend. Procedure-specific mortalities exceeded STS benchmarks, identifying targets for quality improvement. Expanding RENACCAPE and strengthening referral networks remain priorities.
Leyva-López et al. (Thu,) studied this question.