[Effect of Down's syndrome on perioperative and long-term prognosis after ventricular septal defect repair].
In this study, we investigated perioperative and long-term prognosis and the risk of major complications after repair of ventricular septal defect in 48 patients with Down's syndrome who underwent ventricular septal defect repair between May 1980 to August 1999 were compared with those in 48 patients with normal chromosomes matched for age and time period. Pp/Ps were significantly lower after the operation in both groups; however perioperative and postoperative Pp/Ps of Down's syndrome group were significantly higher than that those of control group. The duration of intubation was significantly longer in the Down's syndrome group and the case-control study revealed that the risk of long intubation (> or = 7 days) was significantly higher in the Down's syndrome group, but the incidence of PH crisis did not differ between the 2 groups. The main reasons of prolonged intubation period were respiratory complications such as pneumonia or atelectasis. In Down's syndrome group, a 5 months old boy died of heart failure on the 5th postoperative day. All other patients were survived through a mean follow-up period of 122.4 months (the follow-up rate was 95.8%). In conclusion, the perioperative and long-term prognosis after ventricular septal defect repair in patients with Down's syndrome were similar to those in patients with normal chromosome.
Kashima
I
I
Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
Aeba
R
R
Katougi
T
T
Mitsumaru
A
A
Tsutsumi
K
K
Iino
Y
Y
Koizumi
K
K
Enoki
T
T
Kawada
S
S
D006348:Cardiac Surgical Procedures / Q000401:mortality; D016022:Case-Control Studies; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D011379:Prognosis; D012306:Risk; D015996:Survival Rate; D013997:Time Factors