Down's syndrome affects results of surgical correction of complete atrioventricular canal

From 1981 through June 1989, 59 children had surgery for a complete atrioventricular (AV) canal defect at Oregon Health Sciences University. We compared the morbidity, mortality, and hemodynamic status of 47 children with and 12 without Down's syndrome through review of operative, clinical, and cardiac catheterization records. Overall, 10 children with Down's syndrome have died, nine from cardiac cause within 90 days of surgery. The 2-year survival of these children was 77 +/- 6% as compared to 100% in children without Down's syndrome (p = 0.08). Early age at surgery, the surgical anatomy of the AV canal, and gender had no significant effect on survival. Before surgery, the hemodynamic status of Down's syndrome and non-Down's syndrome children did not differ; in a small group of post-operative catheterization, right heart pressures and pulmonary vascular resistance remained significantly higher in the Down's syndrome as compared to non-Down's syndrome children. These trends to higher mortality and poorer postoperative hemodynamics in children with Down's syndrome may necessitate closer follow-up if confirmed in other cohorts.