Frequency of 22q11 deletions in patients with conotruncal defects.
OBJECTIVE
This study was designed to determine the frequency of 22q11 deletions in a large, prospectively ascertained sample of patients with conotruncal defects and to evaluate the deletion frequency when additional cardiac findings are also considered.


BACKGROUND
Chromosome 22q11 deletions are present in the majority of patients with DiGeorge, velocardiofacial and conotruncal anomaly face syndromes in which conotruncal defects are a cardinal feature. Previous studies suggest that a substantial number of patients with congenital heart disease have a 22q11 deletion.


METHODS
Two hundred fifty-one patients with conotruncal defects were prospectively enrolled into the study and screened for the presence of a 22q11 deletion.


RESULTS
Deletions were found in 50.0% with interrupted aortic arch (IAA), 34.5% of patients with truncus arteriosus (TA), and 15.9% with tetralogy of Fallot (TOF). Two of 6 patients with a posterior malalignment type ventricular septal defect (PMVSD) and only 1 of 20 patients with double outlet right ventricle were found to have a 22q11 deletion. None of the 45 patients with transposition of the great arteries had a deletion. The frequency of 22q11 deletions was higher in patients with anomalies of the pulmonary arteries, aortic arch or its major branches as compared to patients with a normal left aortic arch regardless of intracardiac anatomy.


CONCLUSIONS
A substantial proportion of patients with IAA, TA, TOF and PMVSD have a deletion of chromosome 22q11. Deletions are more common in patients with aortic arch or vessel anomalies. These results begin to define guidelines for deletion screening of patients with conotruncal defects.
The Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania Medical Center, 19104, USA. goldmuntz@email.chop.edu
E
E
Goldmuntz
B J
BJ
Clark
L E
LE
Mitchell
A F
AF
Jawad
B F
BF
Cuneo
L
L
Reed
D
D
McDonald-McGinn
P
P
Chien
J
J
Feuer
E H
EH
Zackai
B S
BS
Emanuel
D A
DA
Driscoll
D001013:Aorta, Thoracic / Q000002:abnormalities; D002648:Child; D002872:Chromosome Deletion; D002892:Chromosomes, Human, Pair 22 / Q000235:genetics*; D004062:DiGeorge Syndrome / Q000235:genetics; D004310:Double Outlet Right Ventricle / Q000235:genetics; D005145:Face / Q000002:abnormalities; D005260:Female; D005820:Genetic Testing; D006330:Heart Defects, Congenital / Q000235:genetics*; D006345:Heart Septal Defects, Ventricular / Q000235:genetics; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000002:abnormalities; D013577:Syndrome; D013771:Tetralogy of Fallot / Q000235:genetics; D014188:Transposition of Great Vessels / Q000235:genetics; D014339:Truncus Arteriosus, Persistent / Q000235:genetics