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Published on: February 8, 2022
Echocardiographic findings in children with surgically correctable non-cardiac congenital anomalies
A I Oyati1, S S Danbauchi, E A Ameh
1Cardiology Unit, Department of Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. oyatialbert@yahoo.com
Insights
Congenital heart disease (CHD) affects over a third of children with surgically corrected non-cardiac congenital malformations. Echocardiography is crucial for pre-surgical screening to identify these co-existing conditions.
Area of Science:
- Pediatric Cardiology
- Congenital Malformations
- Surgical Anesthesia
Background:
- Congenital cardiac anomalies frequently co-exist with non-cardiac congenital malformations.
- Surgical correction of these anomalies carries potential anesthetic risks.
- Estimating the prevalence of co-existing congenital heart disease (CHD) is vital for risk assessment.
Purpose of the Study:
- To determine the incidence of CHD in pediatric patients undergoing surgery for non-cardiac congenital malformations.
- To evaluate the diagnostic utility of echocardiography in identifying these cardiac anomalies pre-operatively.
Main Methods:
- Retrospective analysis of 120 children (1 week to 11 years) undergoing corrective surgery for non-cardiac congenital malformations.
- Review of clinical cardiac examinations, surgical findings, and echocardiographic results.
- Data analysis focused on identifying co-existing cardiac abnormalities.
Main Results:
- The most common non-cardiac anomalies were cleft lip/palate (38.3%) and ano-rectal malformations (26.7%).
- Echocardiography revealed abnormalities in 35% of patients; clinically detected and echocardiographically confirmed CHD occurred in 8.3%.
- Atrial septal defect (ASD) was the most frequent CHD (25%), followed by ventricular septal defect (VSD) (5.8%). ASD was most common in patients with cleft lip/palate.
Conclusions:
- Over one-third of pediatric patients with surgically correctable non-cardiac congenital malformations present with co-existing CHD.
- Pre-surgical echocardiography is essential for detecting these cardiac anomalies.
- No specific association was identified between the type of CHD and particular non-cardiac malformations.
Background:
Congenital cardiac anomalies may co-exist with non-cardiac congenital malformations and, for those requiring surgical correction, there can be an anaesthetic risk.
Aim:
To estimate the burden of congenital heart disease (CHD) in children with surgically correctable non-cardiac congenital malformations.
Patients/Methods:
Records of 120 children aged between 1 week and 11 years [mean (SD) 0.6 (1.5) years] undergoing corrective surgery for non-cardiac congenital malformations were examined. Results of clinical cardiac examination and surgical and echocardiographic findings were analysed.
Results:
Cleft lip or palate was the commonest surgical anomaly (46, 38.3%), followed by ano-rectal malformation (32, 26.7%). Forty-two children (35.0%) had an abnormal echocardiographic scan. A cardiac abnormality was detected clinically and confirmed by echocardiography in ten patients (8.3%), which represents 24% of all the cardiac abnormalities. The commonest cardiac anomalies were atrial septal defect (ASD) (30 children, 25%), followed by ventricular septal defect (VSD) (seven children, 5.8%). The frequency of ASD was highest in children with a cleft lip or palate (14/46, 30.4%).
Conclusions:
Over one-third of patients undergoing surgical correction of congenital malformations have co-existing CHD. Echocardiography is important for pre-surgical evaluation. No association between type of CHD and specific non-cardiac congenital malformations was found.
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