[Impact of Down syndrome on the surgical treatment of congenital heart defects].

OBJECTIVE

To evaluate the impact of Down syndrome (DS) on surgical management in patients with congenital heart defects (CHD).

METHODS

We retrospectively analyzed the clinical data from 35 children with DS and CHD, who underwent cardiac surgery between 2004 and 2009. The data on surgical mortality, complications and follow-up results are emphasized.

RESULTS

All of the patients underwent primary repair. One child (2.9%) with DS and complete atrioventricular septal defect (CAVSD) died early postoperatively because of pulmonary hypertension. Two patients (5.7%) had low cardiac output syndrome, and 15 (42.9%) suffered pulmonary complications. III degree atrioventricular block (AVB) occurred in 4 patients (11.5%). Thirty children who were followed up 10 months to 6 years [(3.8±1.1) years] are in NYHA class I or II. There were no reoperations or later death.

CONCLUSION

CHD in DS children can be repaired with a low risk of mortality, although a high incidence of severe infections and III degree AVB can result in a complicated postoperative course. The results of mid-term follow up are satisfactory.