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Congenital Heart Disease in Patients With Cleft Lip/Palate and Its Impact on Cleft Management

Beina Azadgoli1, Naikhoba C O Munabi1, Artur Fahradyan2

  • 1Division of Plastic and Reconstructive Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|May 29, 2020
PubMed

Insights

Congenital heart disease (CHD) is more common in patients with cleft lip and/or palate (CL/P), especially those with cleft palate. CHD requires careful management alongside cleft treatment to minimize complications like fistulas.

Area of Science:

  • Craniofacial Surgery
  • Pediatric Cardiology
  • Medical Genetics

Background:

  • Congenital heart disease (CHD) is a known comorbidity in patients with cleft lip and/or palate (CL/P).
  • The prevalence and specific associations of CHD within the CL/P population require further elucidation.

Purpose of the Study:

  • To evaluate the characteristics of CHD in patients with CL/P.
  • To assess the association between CHD and cleft outcomes.

Main Methods:

  • Retrospective review of 575 patients with CL/P undergoing primary cleft treatment (2009-2015).
  • Analysis of patient demographics, prenatal/birth characteristics, CL/P details, syndromic status, and postoperative complications.
  • Comparison of patients with (+CHD) versus without (-CHD) congenital heart disease using statistical tests.

Main Results:

  • 14.4% of patients with CL/P (83/575) had CHD.
  • CHD rates were significantly higher in patients with cleft palate (CP) compared to other cleft types (P = .009).
  • Most CHD cases (97.6%) were diagnosed before cleft treatment; 27.7% required cardiac surgery prior to cleft repair. CHD was linked to delayed CP repair and increased fistula rates in isolated CP patients.

Conclusions:

  • Congenital heart disease is notably more prevalent in CL/P patients, particularly those with CP.
  • Severe CHD is typically diagnosed and managed before cleft care.
  • Postoperative fistulas may be more frequent in CL/P patients with CHD, necessitating careful surgical planning and patient optimization.
Abstract

Keywords:
cleft lipcleft palatecongenital heart diseasegenetic syndrome

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