Objective    To evaluate the efficiency of emergency surgery to consecutive 258 infants suffering with critical congenital heart diseases (CHD).     Methods    From January 2006 and February 2009

emergency surgery was performed within 24 h after definite diagnosis on 258 children with critical congenital heart diseases

including 150 males (58.1%) and 108 females (41.9%)

with a mean age of (7.5±4.3) months (ranging from 6 d to 11 months)

at a mean weight of (5.5±3.3) kg (ranging from 2.1 to 9.5 kg). Complications such as refractory pneumonia

heart failure

repeated episodes of hypoxic spells

kidney dysfunction

liver dysfunction

severe anaemia or growth retardation were found in 233 infants (90.2%). Totally 246 (95.3%) of them were operated on CPB with heart arrested

and 12 (4.7%) with patent ductus arteriosus and operated off pump.      Results    This group of patients had a stage-one corrective rate of 92.3%

and a total curative rate of 96.9%. In infants operated with heart arrested and with heart beating

the duration of cardiopulmonary bypass was 105.00±38.71 min and (71.89±27.78) min respectively

postoperative ventilation duration was (16.5±9.3) h

intensive care unit (ICU) staying duration was (98.5±33.6) h. After operation

low cardiac output syndrome occourred with a rate of 6.9% and severe complications of major organs with a rate of 12.9%. Of 8 (3.1%) dead infants

7 were diagnosed with complicated CHD. Five died of low cardiac output syndrome

1 of arrhythmia

1 of respiratory failure and 1 of arrhythmic heart.     Conclusion     Emergency surgical treatment should be performed as soon as definite diagnosis for critical infants with congenital heart disease. Heart failure

respiratory failure

liver dysfunction

severe anaemia and infection are not contraindications to surgical treatment. However

complex anomalies and younger age are considered to be the most risk factors for surgery of infants with CHD.