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Congenital heart disease at a tertiary care center in Lebanon
F F Bitar1, N Baltaji, G Dbaibo
1Department of Pediatrics, American University of Beirut, Lebanon. saad@aub.edu.lb
Insights
Congenital heart disease (CHD) incidence in Lebanon was 11.5/1,000 live births, with more simple defects and higher mortality for complex lesions. A national registry is needed for better care of children with CHD.
Area of Science:
- Pediatric Cardiology
- Epidemiology
- Congenital Abnormalities
Background:
- Congenital heart disease (CHD) presents a significant global health challenge.
- Understanding the epidemiology of CHD is crucial for public health planning and resource allocation.
Purpose of the Study:
- To investigate the incidence and patterns of congenital heart disease (CHD) at the American University of Beirut-Medical Center.
- To analyze the prevalence of different types of CHD, including complex and simple lesions.
Main Methods:
- Retrospective review of medical records for cardiac patients from 1980-1995 and CHD patients in 1995.
- Diagnosis confirmation via echocardiography.
- Exclusion of stillbirths and premature infants with patent ductus arteriosus.
Main Results:
- The incidence of CHD was 11.5 per 1,000 live births.
- A higher prevalence of simple cardiac malformations (e.g., VSD, ASD, pulmonary stenosis) was observed.
- A lower prevalence of complex lesions (e.g., hypoplastic left heart syndrome, transposition of great arteries) was noted.
Conclusions:
- The observed CHD incidence is higher than reported in literature, potentially linked to consanguinity.
- High early mortality for complex lesions may explain their lower prevalence in the study.
- A national pediatric cardiac registry is recommended for improved management of complex CHD in Lebanon.
Objective And Methods:
To study the epidemiology of congenital heart disease (CHD) at the American University of Beirut-Medical Center, we reviewed the medical records of all cardiac patients seen at our outpatient cardiology clinic (OPD) between 1980 and 1995. The charts of all patients with CHD seen as inpatients and/or outpatients at our center during the year 1995 were also reviewed. A cardiologist evaluated all patients and the diagnosis was confirmed at least by echocardiography. The frequency of CHD was reported among three groups: 1980-1995 OPD groups (Group A); the group with CHD seen during the year 1995 (Group B); and (Group C), a subgroup of group B, included all newborns with CHD born at our hospital during the year 1995. Stillbirth and premature infants with the diagnosis of patent ductus arteriosus were excluded from the study.
Results:
Group A included 883 patients. 344 patients were evaluated in Group B, with a mean age of 3.8 years. The incidence of CHD was 11.5/1,000 live births at our center. There was a relatively low prevalence of complex lesions (i.e., hypoplastic left heart syndrome, transposition of the great arteries) and a relatively high prevalence of the simpler cardiac malformation (i.e., ventricular and atrial septal defects, pulmonary stenosis) in Groups A and B.
Conclusion:
The relatively low prevalence of complex cardiac lesions in our study is probably related to the age of the studied patients, and reflects the high mortality of these complex lesions in our country early in life. The incidence of CHD of 11.5/1,000 live births at our center is higher than that reported in the literature, with evidence of more frequent ventricular septal defects and pulmonary atresia lesions. This may be related to high rate of consanguinity in our population. This review underscores the need for a national cardiac registry center for children in a developing country like Lebanon. Such a database will allow referral and care of complex cardiac lesions.