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Cardiac surgery in Down syndrome
A Sheehan1, O C Ward, D F Duff
1Department of Cardiology, Our Lady's Hospital for Sick Children, Dublin.
Irish Medical Journal
|June 1, 1990
Summary
This study analyzed cardiac surgery outcomes for 42 children with Down syndrome and congenital heart disease between 1976-1987. A conservative surgical approach was adopted, resulting in a 6.6% overall mortality rate.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Down Syndrome Research
Background:
- Down syndrome is frequently associated with congenital heart defects.
- Surgical management of these complex conditions presents unique challenges.
- Previous outcomes data for this specific population were limited.
Purpose of the Study:
- To evaluate the outcomes of cardiac surgery in children with Down syndrome and congenital heart disease.
- To assess the mortality and morbidity associated with different surgical procedures.
- To inform surgical decision-making and patient management strategies.
Main Methods:
- Retrospective review of 42 pediatric patients with Down syndrome and congenital heart disease undergoing cardiac surgery between 1976 and 1987.
- Analysis of operative procedures, including repair of patent ductus arteriosus and atrioventricular canal defects.
- Calculation of operative mortality rates for specific procedures and the overall series.
Main Results:
- The most common procedure was patent ductus arteriosus repair.
- Four patients (9.5%) died post-operatively.
- Overall mortality was 6.6%, with higher rates for complex repairs like complete atrioventricular canal defects.
Conclusions:
- A conservative surgical approach was adopted due to factors including life expectancy and lesion complexity in Down syndrome.
- Cardiac surgery in this cohort demonstrated a manageable mortality rate, particularly with less complex procedures.
- Findings support individualized, risk-stratified surgical management for children with Down syndrome and congenital heart disease.
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