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A comparative analysis on risk of pulmonary hypertension in children with Atrio-ventricular (AV) canal defect: a
Josephat Maduabuchi Chinawa1, Chika Onyinyechi Duru2,3, Awoere Tamunosiki Chinawa4
1College of Medicine, Department of pediatrics, University of Nigeria/ University of Nigeria Teaching Hospital (UNTH), Ituku- Ozalla, Enugu State, Nigeria.
Insights
Children with atrioventricular canal defects have a significantly higher risk of developing pulmonary hypertension compared to those with other congenital heart diseases. Early identification and management are crucial for better outcomes.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Research
- Pulmonary Hypertension Studies
Background:
- Atrioventricular canal (AVC) defects are a significant subset of congenital heart disease.
- Pulmonary hypertension (PH) is a serious complication in children with congenital heart defects.
- Understanding the specific risks associated with AVC defects is crucial for clinical management.
Purpose of the Study:
- To determine the risk of pulmonary hypertension in pediatric patients with atrioventricular canal defects.
- To compare this risk against children diagnosed with other forms of congenital heart disease.
- To identify clinical factors associated with pulmonary hypertension in this population.
Main Methods:
- A descriptive, multi-institutional study conducted over six years.
- Inclusion of children with atrioventricular canal defects and a control group with other congenital heart defects.
- Statistical analysis to compare the incidence of pulmonary hypertension and clinical symptoms.
Main Results:
- A high proportion (77.5%) of children with AVC defects presented with pulmonary hypertension.
- Children with AVC defects demonstrated statistically significant higher odds of developing pulmonary hypertension and clinical symptoms compared to controls.
- While a positive correlation was observed between PH and the size of VSD and ASD, it was not statistically significant.
Conclusions:
- The majority of children with AVC defects exhibit pulmonary hypertension.
- Children with AVC defects face elevated risks for pulmonary hypertension and associated clinical symptoms.
- These findings underscore the heightened vulnerability of AVC defect patients to pulmonary hypertension.
Objectives:
This study is aimed at determining the risk of pulmonary hypertension in children with AV canal defect when compared with children with other congenital heart disease.
Methods:
A descriptive study carried out in three institutions over a six-year period among children who presented with AV canal defect and their controls who presented with other congenital heart defects.
Results:
A large proportion of the children with AV canal (77.5%) had pulmonary hypertension. Among the patients with pulmonary hypertension, 45.2% were males compared 54.8% females (χ2 = 3.2, p = 0.2). There was a positive correlation between pulmonary hypertension and size of VSD and ASD, although the correlation was not significant (Pearson correlation coefficient = 0.01 and 0.4, p = 0.9 and 0.1 respectively). Children with AV canal defect had higher odds of developing most clinical symptoms and pulmonary hypertension than children with other congenital heart disease and this is statistically significant.
Conclusion:
Majority of children with AV canal defect presented with pulmonary hypertension. These children present with higher odds of having pulmonary hypertension and clinical symptoms than children with other types of congenital heart disease.
