title: Cardiac Surgical Repair Should Be Offered to Infants with Trisomy 18, Interrupted Aortic Arch and Ventricular Septal Defect.
abstract: The management of children born with trisomy 18 is controversial, and both providers and parents often have differing opinions. Many parents choose to terminate the pregnancy while others go forward, making decisions based on their beliefs, understanding, and physician recommendations. Physicians are similarly divided regarding treatment of these children, as some feel that aggressive treatments are futile while others defer to the parents' wishes.Interrupted aortic arch with ventricular septal defect in children with trisomy 18 presents an ethical dilemma that highlights the kinds of controversies in medical decision making facing physicians on a daily basis. Repair of interrupted aortic arch with ventricular septal defect poses a high risk to newborns with or without trisomy 18. Therefore, the option for surgery should be treated as with any routine informed consent process. Parents should be counseled about the risks, benefits, alternatives, and the likelihood of success both short and long term and be should offered a choice between surgery and palliative care.
authors.affiliation: Minoo N. Kavarana, M.D., has been a pediatric cardiac surgeon at the Medical University of South Carolina since 2010. He is an Associate Professor in the Section of Pediatric Cardiac Surgery at MUSC. He completed his fellowship in congenital heart surgery at the University of Michigan, his cardiothoracic surgery fellowship at the University of Louisville, and his general surgery residency at New York Medical College.
authors.forename: Minoo N
authors.initials: MN
authors.lastname: Kavarana
mesh_terms: D001013:Aorta, Thoracic / Q000473:pathology*; D013504:Cardiovascular Surgical Procedures / Q000941:ethics*; D003376:Counseling; D003657:Decision Making; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D007223:Infant; D014314:Trisomy; D000073842:Trisomy 18 Syndrome