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[Congenital heart defects. Frequency at autopsy]
Insights
Congenital heart disease (CHD) affects 26.5% of pediatric autopsies, with ventricular septal defects being most common. Most deaths occurred within the first year of life, often with associated cardiac or extracardiac anomalies.
Area of Science:
- Pediatric Pathology
- Cardiovascular Science
- Medical Genetics
Context:
- Autopsy data from 3,071 stillborns and children up to 16 years (1969-1983).
- Focus on congenital heart disease (CHD) prevalence and characteristics.
Purpose:
- To analyze the spectrum and frequency of congenital heart disease in a large pediatric autopsy cohort.
- To identify common CHD malformations, associated anomalies, and demographic patterns.
Summary:
- Congenital heart disease (CHD) was identified in 26.5% of pediatric autopsies.
- Ventricular septal defects, d-transposition of great vessels, tetralogy of Fallot, and aortic coarctations were most frequent.
- The majority of deaths (78.8%) occurred within the first year of life, with 20.1% in the perinatal period.
- Associated cardiac anomalies were present in 81.8% of CHD cases; extracardiac malformations occurred in 7.2%.
Impact:
- Provides crucial epidemiological data on pediatric CHD for pathology and cardiology research.
- Highlights the high rate of associated anomalies, emphasizing the complexity of CHD management.
- Informs clinical practice and future research directions in pediatric cardiovascular health.
Abstract:
Autopsies were performed on 3,071 stillborns and decreased children up to the age of 16 years at the Institute of Pathology of the Charité from 1969 to 1983. Congenital heart disease (CHD) was found in 814, i.e. 26.5% of the autopsies. Results of re-examination of 642 hearts with CHD are discussed. The most common malformations are ventricular septal defects, d-transpositions of the great vessels, tetralogy of Fallot and aortic coarctations. CHD was more frequently found in boys than in girls (1.5 : 1). The majority of the deaths occurred during the first year of life (78.8%). 20.1% of these took place during the perinatal period and 47.2% within the first 6 months of life. Additional cardiac anomalies were associated with the main defect in 81.8% of cases. The most common such associated defects were atrial and ventricular septal defects, aortic coarctations and other aortic arch anomalies. The frequency of extracardiac malformations in CHD was 7.2%. The most common anomalies were of the central nervous system, the gastrointestinal tract and the urinary system. Malformation syndromes were identified in 5.6% of the CHD cases, including Down's syndrome in 1.4%.