Congenital heart disease in children with Down's syndrome: Turkish experience of 13 years.
BACKGROUND
Down's syndrome (DS) is the most common chromosomal abnormality due to a trisomy of chromosome 21 commonly associated with congenital heart defects (CHDs). This study aimed to evaluate the frequency and types of CHD patterns in Turkish children with DS.


METHODS
The data relate to paediatric patients with DS who underwent cardiologic screening between 1994 and 2007 and were reviewed in our Paediatric Cardiology unit.


RESULTS
Four hundred and twenty-one out of the 1042 paediatric patients with DS studied over a 13-year period had associated CHD. Of these, 320 (77.6%) had a single cardiac lesion, while the remaining 92 patients (22.4%) had multiple defects. The most common single defect was an atrioventricular septal defect (AVSD) found in 141 patients (34.2%), followed by 69 patients (16.7%) showing secundum type atrial septal defect, and ventricular septal defect in 68 patients (16.5%). AVSDs were the leading type, isolated or combined with other cardiac anomalies with an overall occurrence of 19.8% of paediatric patients with DS, and 49.2% of paediatric patients with both DS and CHD.


CONCLUSIONS
This is the first study concerning the frequency and type of CHD observed in Turkish children with DS. The high frequency of AVSD in Turkish children with DS implied that early screening for CHDs by echocardiography is crucial. The correction of AVSDs in paediatric patients with DS should be performed in the first 6 months of life to avoid irreversible haemodynamic consequences of the defect.
Nisli
Kemal
K
Paediatric Cardiology Division, Paediatrics Department, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. kemalnisli@yahoo.com
Oner
Naci
N
Candan
Sukru
S
Kayserili
Hulya
H
Tansel
Turkan
T
Tireli
Emin
E
Karaman
Birsen
B
Omeroglu
Rukiye Eker
RE
Dindar
Aygun
A
Aydogan
Umrah
U
Başaran
Seher
S
Ertugrul
Turkan
T
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000453:epidemiology; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology; D014463:Ultrasonography