title: Outcomes of cardiac surgery in trisomy 18 patients.
abstract: OBJECTIVE
  The objective was to clarify the outcomes of cardiac surgery in trisomy 18 patients.
  
  
  METHODS
  We analysed 34 consecutive trisomy 18 patients, of whom 21 were males, with cardiac complications. They were divided into patients who underwent cardiac surgery and those who were conservatively treated. We compared rates of survival and discharge alive between two groups.
  
  
  RESULTS
  The surgery group included nine patients, with six males, who underwent cardiac surgery - intracardiac repair in three patients, pulmonary arterial banding in five patients, and ligation of the ductus in one patient - at median age of 2.2 months, ranging from 0.5 to 9.8, and with median weight of 2.6 kilograms, ranging from 1.5 to 3.2. Cardiac surgery and pre-operative assisted ventilation were hazardous factors leading to death. In the surgery group, cumulative survival rates at 1 month, 6 months, 12 months, and 24 months were 63%, 38%, 25%, and 22%, respectively, compared with 51%, 26%, 9%, and 9% in the conservative group. There was a significant difference (p = 0.002). The cumulative rates of discharge alive at 1 month, 3 months, and 6 months were 0%, 12%, and 65% in the surgery group, which did not differ from the conservative group (p = 0.80).
  
  
  CONCLUSIONS
  Cardiac surgery contributed to increased survival rate but not the rate of discharge alive in trisomy 18 patients. Cardiac surgery could not prevent all the trisomy 18 patients from death. The indication of cardiac surgery should be carefully individualised to improve the quality of life in trisomy 18 patients and concerned surrounding people.
authors.affiliation: Department of Pediatrics, Kyushu Koseinenkin Hospital, Kishinoura, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan. mune@pediatr.med.kyushu-u.ac.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Muneuchi
authors.forename: Junko
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Mamie
authors.initials: M
authors.lastname: Watanabe
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Yuge
authors.forename: Takuro
authors.initials: T
authors.lastname: Ohno
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imoto
authors.forename: Akira
authors.initials: A
authors.lastname: Sese
authors.forename: Kunitaka
authors.initials: K
authors.lastname: Joo
mesh_terms: D006348:Cardiac Surgical Procedures; D002887:Chromosomes, Human, Pair 18 / Q000235:genetics; D005260:Female; D006330:Heart Defects, Congenital / Q000235:genetics / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014314:Trisomy / Q000235:genetics