The Outcome of Congenital Cardiac Surgery in Patients with Down Syndrome: Single-Center Experience

Authors

  • Abdulhameed A. Alnajjar Pediatric Cardiac Services, Madinah Cardiac Center MCC, 42210 Madinah, Saudi Arabia
  • Sherif S. Salem Pediatric Cardiac Services, Madinah Cardiac Center MCC, 42210 Madinah, Saudi Arabia; Pediatric Department, Faculty of Medicine, Menoufia University, 32951 Menoufia, Egypt
  • Luna S. Baangood Pediatric Cardiac Services, Madinah Cardiac Center MCC, 42210 Madinah, Saudi Arabia
  • Mansour B. Al-Mutairi Pediatric Cardiac Services, Madinah Cardiac Center MCC, 42210 Madinah, Saudi Arabia
  • Mohamed F. Morsy Pediatric Cardiac Services, Madinah Cardiac Center MCC, 42210 Madinah, Saudi Arabia; Pediatric Department, Faculty of Medicine, Sohag University, 82511 Sohag, Egypt
  • Mustafa Al-Muhaya Pediatric Cardiac Services, Madinah Cardiac Center MCC, 42210 Madinah, Saudi Arabia
  • Alassal A. Alkodami Pediatric Cardiac Services, Madinah Cardiac Center MCC, 42210 Madinah, Saudi Arabia
  • Merhamer L. Sabtirul Pediatric Cardiac Services, Madinah Cardiac Center MCC, 42210 Madinah, Saudi Arabia
  • Mohamed S. Hussein Pediatric Cardiac Services, Madinah Cardiac Center MCC, 42210 Madinah, Saudi Arabia
  • Eman W. Altommeihi Pediatric Cardiac Services, Madinah Cardiac Center MCC, 42210 Madinah, Saudi Arabia
  • Ahmed M. Shaban Pediatric Cardiac Services, Madinah Cardiac Center MCC, 42210 Madinah, Saudi Arabia; Cardiothoracic Surgery Department, Faculty of Medicine, Suez Canal University, 41522 Suez Canal, Egypt
  • Mohamed Alashwal Pediatric Cardiac Services, Madinah Cardiac Center MCC, 42210 Madinah, Saudi Arabia
  • Ayman R. Abdelrehim Pediatric Cardiac Services, Madinah Cardiac Center MCC, 42210 Madinah, Saudi Arabia; Cardiothoracic Surgery Department, Faculty of Medicine, Menoufia University, 32951 Menoufia, Egypt https://orcid.org/0000-0002-1947-2839

DOI:

https://doi.org/10.59958/hsf.5795

Keywords:

cardiac surgery, Down syndrome, congenital heart defects, mortality, outcomes

Abstract

Objectives: This study aimed to describe the outcomes of Down syndrome patients who underwent cardiac surgery for congenital heart defects and to develop risk prediction models for in-hospital mortality, recurrent hospital admission, and the need for catheter intervention among a cohort of patients. Methods: This single-centre retrospective cohort study included consecutive Down syndrome patients who underwent cardiac surgery for congenital heart defects between January 2018 and December 2021. We reviewed the electronic medical records. Two hundred patients fulfilled the eligibility criteria with complete data reporting. The patients' perioperative data and outcomes were recorded. Results: Females constituted 56.5%. Most (78.5%) patients showed accepted recovery. The incidence of all-cause in-hospital mortality was 3.0%. The rates of the need for a second operation, heart failure management, and permanent pacemaker insertion were 3.0%, 2.0%, and 2.5%, respectively. Only 8 (4.0%) patients stayed in the hospital for a long duration after chylothorax or tracheostomy (if intubated more than 2 weeks). The model had an accuracy of 99% and included the intraoperative transesophageal echocardiography (TEE) abnormalities (residual heart lesions) (adjusted odds ratio [AOR]: 26.541, p = 0.033), the duration of mechanical ventilation following the operation (AOR: 1.152, p = 0.009), and the occurrence of postoperative heart block (AOR: 76.447, p = 0.005). Conclusion: Surgical treatment of congenital heart defects in Down syndrome patients had good outcomes with accepted recovery (without intra-hospital or during follow-up mortality or morbidity) of 78.5% and a 3% incidence of in-hospital mortality. Though, the occurrence of chylothorax was considerably high, and resulted in a long hospital stay (more than 10 days). Repair of tetralogy of Fallot and coarctation of the aorta were associated with an increased likelihood of catheter intervention following the operation.

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Published

2023-08-24

How to Cite

Alnajjar, A. A., Salem, S. S., Baangood , L. S., Al-Mutairi, M. B., Morsy, M. . F., Al-Muhaya, M., Alkodami, A. A., Sabtirul, M. L., Hussein, M. S., Altommeihi, E. W., Shaban, A. M., Alashwal, M., & Abdelrehim, A. R. (2023). The Outcome of Congenital Cardiac Surgery in Patients with Down Syndrome: Single-Center Experience. The Heart Surgery Forum, 26(4), E372-E380. https://doi.org/10.59958/hsf.5795

Issue

Vol. 26 No. 4 (2023)

Section

Article
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