scholarly journals Clinical assessment for diagnosing congenital heart disease in newborn infants with Down syndrome

2019 ◽  
Author(s):  
William McGuire ◽  
Peter W Fowlie ◽  
Johannes B Reitsma
Keyword(s):  
Congenital Heart Disease ◽  
Down Syndrome ◽  
Heart Disease ◽  
Clinical Assessment ◽  
Congenital Heart ◽  
Newborn Infants

scholarly journals Down syndrome and congenital heart disease: perioperative planning and management

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Dennis R. Delany ◽  
Stephanie S. Gaydos ◽  
Deborah A. Romeo ◽  
Heather T. Henderson ◽  
Kristi L. Fogg ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Down Syndrome ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Single Ventricle ◽  
Heart Defects ◽  
Careful Consideration ◽  
Children With Down Syndrome ◽  
Perioperative Planning

AbstractApproximately 50% of newborns with Down syndrome have congenital heart disease. Non-cardiac comorbidities may also be present. Many of the principles and strategies of perioperative evaluation and management for patients with congenital heart disease apply to those with Down syndrome. Nevertheless, careful planning for cardiac surgery is required, evaluating for both cardiac and noncardiac disease, with careful consideration of the risk for pulmonary hypertension. In this manuscript, for children with Down syndrome and hemodynamically significant congenital heart disease, we will summarize the epidemiology of heart defects that warrant intervention. We will review perioperative planning for this unique population, including anesthetic considerations, common postoperative issues, nutritional strategies, and discharge planning. Special considerations for single ventricle palliation and heart transplantation evaluation will also be discussed. Overall, the risk of mortality with cardiac surgery in pediatric patients with Down syndrome is no more than the general population, except for those with functional single ventricle heart defects. Underlying comorbidities may contribute to postoperative complications and increased length of stay. A strong understanding of cardiac and non-cardiac considerations in children with Down syndrome will help clinicians optimize perioperative care and long-term outcomes.

scholarly journals Association Between Down Syndrome and In-Hospital Death Among Children Undergoing Surgery for Congenital Heart Disease

2014 ◽  
Vol 7 (3) ◽  
pp. 445-452 ◽  
Author(s):  
Jacqueline M. Evans ◽  
Madan Dharmar ◽  
Erin Meierhenry ◽  
James P. Marcin ◽  
Gary W. Raff
Keyword(s):  
Congenital Heart Disease ◽  
Down Syndrome ◽  
Heart Disease ◽  
Congenital Heart ◽  
Hospital Death

scholarly journals Prevalence and profile of congenital heart disease and pulmonary hypertension in Down syndrome in a pediatric cardiology service

2014 ◽  
Vol 32 (2) ◽  
pp. 159-163 ◽  
Author(s):  
Felipe Alves Mourato ◽  
Lúcia Roberta R. Villachan ◽  
Sandra da Silva Mattos
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Down Syndrome ◽  
Heart Disease ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Diseases ◽  
Heart Defects ◽  
Descriptive Analysis ◽  
Atrioventricular Septal Defect

OBJECTIVE:To determine the frequence and profile of congenital heart defects in Down syndrome patients referred to a pediatric cardiologic center, considering the age of referral, gender, type of heart disease diagnosed by transthoracic echocardiography and its association with pulmonary hypertension at the initial diagnosis.METHODS:Cross-sectional study with retrospective data collection of 138 patients with Down syndrome from a total of 17,873 records. Descriptive analysis of the data was performed, using Epi-Info version 7.RESULTS: Among the 138 patients with Down syndrome, females prevailed (56.1%) and 112 (81.2%) were diagnosed with congenital heart disease. The most common lesion was ostium secundum atrial septal defect, present in 51.8%, followed by atrioventricular septal defect, in 46.4%. Ventricular septal defects were present in 27.7%, while tetralogy of Fallot represented 6.3% of the cases. Other cardiac malformations corresponded to 12.5%. Pulmonary hypertension was associated with 37.5% of the heart diseases. Only 35.5% of the patients were referred before six months of age.CONCLUSIONS: The low percentage of referral until six months of age highlights the need for a better tracking of patients with Down syndrome in the context of congenital heart disease, due to the high frequency and progression of pulmonary hypertension.

Targeted Next-Generation Sequencing of 406 Genes Identified Genetic Defects Underlying Congenital Heart Disease in Down Syndrome Patients

2018 ◽  
Vol 39 (8) ◽  
pp. 1676-1680 ◽  
Author(s):  
Khalid M. Alharbi ◽  
Abdelhadi H. Al-Mazroea ◽  
Atiyeh M. Abdallah ◽  
Yousef Almohammadi ◽  
S. Justin Carlus ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Down Syndrome ◽  
Heart Disease ◽  
Next Generation Sequencing ◽  
Congenital Heart ◽  
Genetic Defects ◽  
Next Generation ◽  
Targeted Next Generation Sequencing ◽  
Generation Sequencing

scholarly journals Multi‐Institutional Practice‐Patterns in Fetal Congenital Heart Disease Following Implementation of a Standardized Clinical Assessment and Management Plan

2021 ◽  
Author(s):  
Yalda Afshar ◽  
Whitnee J. Hogan ◽  
Charlotte Conturie ◽  
Sherzana Sunderji ◽  
Jennifer Y. Duffy ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Clinical Assessment ◽  
Congenital Heart ◽  
Intervention Group ◽  
Management Plan ◽  
University Of California ◽  
Maternal Risk ◽  
Early Term ◽  
Term Delivery

Background Prenatal diagnosis of congenital heart disease has been associated with early‐term delivery and cesarean delivery (CD). We implemented a multi‐institutional standardized clinical assessment and management plan (SCAMP) through the University of California Fetal‐Maternal Consortium. Our objective was to decrease early‐term (37–39 weeks) delivery and CD in pregnancies complicated by fetal congenital heart disease using a SCAMP methodology to improve practice in a high‐risk and clinically complex setting. Methods and Results University of California Fetal‐Maternal Consortium site‐specific management decisions were queried following SCAMP implementation. This contemporary intervention group was compared with a University of California Fetal‐Maternal Consortium historical cohort. Primary outcomes were early‐term delivery and CD. A total of 496 maternal–fetal dyads with prenatally diagnosed congenital heart disease were identified, 185 and 311 in the historical and intervention cohorts, respectively. Recommendation for later delivery resulted in a later gestational age at delivery (38.9 versus 38.1 weeks, P =0.01). After adjusting for maternal age and site, historical controls were more likely to have a CD (odds ratio [OR],1.8; 95% CI, 2.1–2.8; P =0.004) and more likely (OR, 2.1; 95% CI, 1.4–3.3) to have an early‐term delivery than the intervention group. Vaginal delivery was recommended in 77% of the cohort, resulting in 61% vaginal deliveries versus 50% in the control cohort ( P =0.03). Among pregnancies with major cardiac lesions (n=373), vaginal birth increased from 51% to 64% ( P =0.008) and deliveries ≥39 weeks increased from 33% to 48% ( P =0.004). Conclusions Implementation of a SCAMP decreased the rate of early‐term deliveries and CD for prenatal congenital heart disease. Development of clinical pathways may help standardize care, decrease maternal risk secondary to CD, improve neonatal outcomes, and reduce healthcare costs.

Screening for Congenital Heart Disease in Infants with Down Syndrome: Is Universal Echocardiography Necessary?

2016 ◽  
Vol 37 (7) ◽  
pp. 1222-1227 ◽  
Author(s):  
Soujanya Bogarapu ◽  
Nelangi M. Pinto ◽  
Susan P. Etheridge ◽  
Xiaoming Sheng ◽  
Kirk N. Liesemer ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Down Syndrome ◽  
Heart Disease ◽  
Congenital Heart

GASTRIC RESPONSE TO SPECIFIC DISEASE IN INFANTS

PEDIATRICS ◽  
1966 ◽  
Vol 38 (5) ◽  
pp. 874-878
Author(s):  
Gordon B. Avery ◽  
Judson G. Randolph ◽  
Thomas Weaver
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Newborn Infants ◽  
Chloride Concentration ◽  
Acid Formation ◽  
Total Acidity ◽  
Pepsin Activity ◽  
Specific Disease ◽  
Normal Acidity

1. A method of gastric analysis has been developed for the study of newborn infants. Results obtained with this method have shown it to reflect more accurately the ongoing secretory activity of the stomach. Previous methods of sampling left significant and varying amounts of acidity behind in the stomach rendering much of the available data inconclusive. 2. For the first time, gastric function has been correlated with specific disease states in the infant. 3. The volume, pH, total acidity, chloride content, and pepsin activity have been found to vary independently of one another. 4. Pneumonia and bronchiolitis, two conditions producing compromised respiratory function, were characterized by decreased total acidity, a more alkaline pH, and decreased pepsin activity. 5. Infants with short gut after bowel resection displayed highly significant increases in total gastric acidity and rate of acid formation, and a lower gastric pH. 6. Infants with acyanotic congenital heart disease showed significantly decreased pepsin content and increased chloride concentration despite normal acidity. Conversely, the few infants with cyanotic congenital heart disease studied had decreased volume of gastric juice and rate of acid formation.

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