title: Congenital heart defects in newborns with apparently isolated single gastrointestinal malformation: A retrospective study.
abstract: Congenital gastrointestinal system malformations/abdominal wall defects (GISM) may appear as isolated defects (single or complex), or in association with multiple malformations. The high incidence of association of GISM and congenital heart defects (CHD) in patients with syndromes and malformative sequences is known, but less expected is the association of apparently isolated single GISM and CHD. The aim of this study was to investigate the frequency of CHD in newborns with isolated GISM, and the possibility to modify the diagnostic-therapeutic approach just before the onset of cardiac symptoms or complications.
  
  
  
  Anamnestic, clinical, and imaging data of newborns requiring abdominal surgery for GISM, between 2009 and 2014, were compared with a control group of healthy newborns. Distribution of GISM and cardiovascular abnormalities were analyzed, and risk factors for adverse outcomes were identified.
  
  
  
  Seventy-one newborns with isolated GISM were included in this study. More frequent GISM were intestinal rotation and fixation disorders. CHD were observed in 15.5% of patients, augmenting their risk for morbidity. Risk factors for morbidity related to sepsis were identified in central venous catheter, intestinal stoma, and H2-inhibitor-drugs. Moreover, 28.2% of newborns presented only functional cardiac disorders but an unexpectedly higher mortality.
  
  
  
  The high incidence of congenital heart disease in infants with apparently isolated GISM confirms the need to perform an echocardiographic study before surgery to improve perioperative management and prevent complications such as sepsis and endocarditis.
authors.affiliation: Neonatal Intensive Care Unit, AOUP, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Via Alfonso Giordano n. 3, 90127 Palermo, Italy. Electronic address: inschier@tin.it.
authors.forename: Ingrid Anne Mandy
authors.initials: IA
authors.lastname: Schierz
authors.affiliation: Neonatal Intensive Care Unit, AOUP, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Via Alfonso Giordano n. 3, 90127 Palermo, Italy. Electronic address: giusypinello@gmail.com.
authors.forename: Giuseppa
authors.initials: G
authors.lastname: Pinello
authors.affiliation: Neonatal Intensive Care Unit, AOUP, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Via Alfonso Giordano n. 3, 90127 Palermo, Italy. Electronic address: mario.giuffre@unipa.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Giuffrè
authors.affiliation: Neonatal Intensive Care Unit, AOUP, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Via Alfonso Giordano n. 3, 90127 Palermo, Italy. Electronic address: simonalaplaca@libero.it.
authors.forename: Simona
authors.initials: S
authors.lastname: La Placa
authors.affiliation: Neonatal Intensive Care Unit, AOUP, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Via Alfonso Giordano n. 3, 90127 Palermo, Italy. Electronic address: ettore.piro@unipa.it.
authors.forename: Ettore
authors.initials: E
authors.lastname: Piro
authors.affiliation: Neonatal Intensive Care Unit, AOUP, Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Via Alfonso Giordano n. 3, 90127 Palermo, Italy. Electronic address: giocors@aliceposta.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corsello
mesh_terms: D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D041981:Gastrointestinal Tract / Q000002:abnormalities*; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies
keywords: Cardiovascular abnormalities; Congenital abnormalities; Digestive system abnormalities; Intestinal atresia; Mesenterium defect; Ventricular septal defect