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Profile of congenital heart disease and correlation to risk adjustment for surgery; an echocardiographic study
1Paediatric Cardiology Department, Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi. khurramadiba@gmail.com
Insights
Congenital heart disease (CHD) profiles in children reveal Ventricular Septal Defects (VSD) and Tetralogy of Fallot (TOF) as most common. Most surgical candidates fall into risk category 2 using the RACHS-1 scoring system.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Research
- Echocardiography Applications
Background:
- Congenital Heart Diseases (CHD) are a significant concern in pediatric populations.
- Understanding the pattern and profile of CHD is crucial for effective management and surgical risk assessment.
- Tertiary referral centers play a vital role in diagnosing and treating complex pediatric cardiac conditions.
Purpose of the Study:
- To determine the pattern and profile of Congenital Heart Diseases (CHD) in pediatric patients.
- To analyze the correlation of CHD profiles with surgical risk adjustment scoring systems.
- To provide data from a pediatric tertiary referral center for improved clinical decision-making.
Main Methods:
- A descriptive case series design was employed.
- Data was collected over six months from 1149 pediatric patients undergoing 2-D echocardiography.
- Non-probability purposive sampling was utilized at the Armed Forces Institute of Cardiology/National Institute of Heart Diseases.
Main Results:
- Twenty-five percent of referred cases had normal hearts.
- Ventricular Septal Defects (VSD) (24%) and Tetralogy of Fallot (TOF) (10%) were the most prevalent CHD types.
- Most cases fell into category 2 of the Risk Adjustment for Congenital Heart Surgery (RACHS-1) scoring system.
Conclusions:
- VSD and TOF represent the primary diagnoses within the studied pediatric CHD population.
- The majority of patients recommended for CHD surgery were classified under RACHS-1 risk categories 1 and 2.
- This profiling aids in understanding disease prevalence and surgical risk stratification in pediatric cardiology.
Objective:
To determine the pattern and profile of Congenital Heart Diseases (CHD) in paediatric patients (age 1 day to 18 years) presenting to a paediatric tertiary referral centre and its correlation to risk adjustment for surgery for congenital heart disease.
Study Design:
Descriptive case series.
Place And Duration Of Study:
Paediatric Cardiology Department, Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi (AFIC/NIHD).
Patients And Methods:
Over a period of 6 months, 1149 cases underwent 2-D echocardiography. It was a non-probability purposive sampling.
Results:
This study showed 25% of all referrals had normal hearts. A male preponderance (38%) was observed from 1 year to 5 years age group. Nineteen percent of the cases were categorized as cyanotic CHD with the remaining as acyanotic variety. Tetralogy of Fallot (TOF) represented 10%, Ventricular Septal Defects (VSD) 24%, followed by Patent Ductus Arteriosus (PDA) and Atrial Septal Defect (ASD), which comprised 6.6% and 6.5% respectively. VSD was the most common association in patients with more complex CHD (10%) followed by PDA in 3% and ASD in 1.2% of the cases. Most of the cases were category 2 in the RACHS-1 scoring system.
Conclusion:
VSD and TOF formed the major groups of cases profiled. Most of the cases recommended for surgery for congenital heart disease belonged to the risk category 2 (28.1%) followed by the risk category 1 (12.7%) of the RACHS-1 scoring system.
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