[Risks and benefits of cardiac surgery in Down's syndrome with congenital heart disease].
Down's syndrome is the most frequent chromosomic anomaly. Fifty percent are associated with a congenital heart disease. Life expectancy and quality of life are increasing since 15 years with improving surgical techniques.


METHODS
This study presents 73 patients with Down's syndrome who underwent a surgical repair of congenital heart disease between 1992 and 2002. Among them, 37 (50.6%) had a complete atrio-ventricular septal defect (AVSD) and 36 an other anomaly.


RESULTS
Five children died in the post operative period: all had an AVSD. Two late deaths occurred due to extra cardiac causes during the follow up. Two children who underwent a repair of AVSD had to be reoperated. The majority of the children are doing well, without any cardiac symptom. Thirty-eight percent of patients with AVSD repair have a middle mitral or tricuspid regurgitation and three had a massive mitral or tricuspid regurgitation. One child presents neurological sequelae related to surgery.


CONCLUSIONS
Congenital heart diseases in Down's syndrome can be repaired with a limited risk of death. Final results are good for many children with significant improvement of the quality of life and life expectancy.
Stos
B
B
Service de cardiologie pédiatrique, cliniques universitaires Saint-Luc, UCL, 10, avenue Hippocrate, 1200 Bruxelles, Belgique.
Dembour
G
G
Ovaert
C
C
Barrea
C
C
Arape
A
A
Stijns
M
M
Sluysmans
T
T
D006348:Cardiac Surgical Procedures / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications*; D006330:Heart Defects, Congenital / Q000150:complications* / Q000601:surgery*; D006343:Heart Septal Defects / Q000150:complications / Q000601:surgery; D006801:Humans; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome