Genetic heterogeneity and phenotypic anomalies in children with atrioventricular canal defect and tetralogy of Fallot.
Tetralogy of Fallot associated with the atrioventricular canal defect has been usually reported in association with Down syndrome. The aim of the present study was to describe the cardiac aspects and the genetic anomalies in children with this association of heart defects. We identified 64 patients with atrioventricular canal defect tetralogy of Fallot. All children underwent complete cardiovascular, clinical phenotypic and genetic evaluation. A genetic syndrome or extracardiac anomalies were found in 56 patients (87.5%). Down syndrome (43 patients, 67.2%) was the most frequent genetic diagnosis. Other syndromes were 8p deletion, trisomy 13, duplication 5p, cranio-cerebello-cardiac syndrome, Cantrell syndrome, CHARGE association, VACTERL association, and DiGeorge syndrome related to maternal diabetes. No patients in our series had 22q11 deletion. Tetralogy of Fallot with extreme dextroposition of the aorta was found in seven patients (only one with Down syndrome). Additional cardiac malformations were present in 23 patients (only 11 with Down syndrome). The association between atrioventricular canal defect and tetralogy of Fallot represents a cardiac phenotype with strong genetic characteristics. For this reason, a careful genetic examination is required. Our study confirms the high prevalence of Down syndrome, but also reveals a significant genetic heterogeneity. Additional cardiac defects are prevalent in patients without Down syndrome.
Department of Pediatrics, University La Sapienza, Rome, Italy.
Pasquale
P
Vergara
Maria Cristina
MC
Digilio
Andrea
A
De Zorzi
Duccio
D
Di Carlo
Rossella
R
Capolino
Alessandro
A
Rimini
Monica
M
Pelegrini
Raffaele
R
Calabro
Bruno
B
Marino
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004694:Endocardial Cushion Defects / Q000150:complications* / Q000453:epidemiology / Q000235:genetics*; D005260:Female; D018740:Genetic Heterogeneity; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010641:Phenotype; D013771:Tetralogy of Fallot / Q000150:complications* / Q000235:genetics*