[Change in our approach in the surgical management of congenital heart defects in patients with Down syndrome, 1974-2016].
BACKGROUND
Congenital heart defects are frequently present in patients with Down syndrome.


OBJECTIVE
The authors analyzed the impact of changing approach in surgical management of congenital heart defect on the life expectancy of patients with Down syndrome.


METHODS
Between 1974 and 1997 the data of 359 children with Down syndrome were collected. Among them 255 patients had no surgery and the mortality in this group was 25.9%, whereas the mortality in the group of 104 patients who underwent palliative surgery was 8.6%.


RESULTS
Surgical management of congenital heart defects provides the same life expectancy for these patients as compared to Down patients without cardiac defects. Primary reconstruction is the preferable surgical procedure in infancy that provides good results. Nowadays the number of the operated grown-up congenital heart disease patients with Down syndrome is increasing. During the last three years 82 grown-up congenital heart disease patients, including 4 patients with Down syndrome (aged between 24 and 60 years) were reconstructed successfully.


CONCLUSIONS
Due to the successful surgery in infancy the population of grown-up congenital heart disease patients with Down syndrome is increasing. The cardiac surgeons are ready to do everything for the optimal life expectancy of these patients. However, management of special problems (indication and necessity of reoperation, optimal age) in patients with Down syndrome poses a great challenge for cardiologists and cardiac surgeons. Orv. Hetil., 2016, 157(40), 1601-1603.
II. Belgyógyászati Klinika, Szívsebészeti Osztály, Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ Szeged, Pécsi u. 4., 6720.
István
I
Hartyánszky
II. Belgyógyászati Klinika, Szívsebészeti Osztály, Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ Szeged, Pécsi u. 4., 6720.
Gábor
G
Bogáts
D002648:Child; D004314:Down Syndrome / Q000150:complications* / Q000401:mortality*; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008017:Life Expectancy; D008297:Male; D010166:Palliative Care; D011379:Prognosis; D012959:Socioeconomic Factors
Down syndrome; Down-szindróma; GUCH; cardiac surgical management; felnőttkori congenitalis szívbetegek; sebészi kezelés