| Autor: |
Khor, K, Finucane, AK, Sadler, L, Parry, E, Wright, J, Beca, J, Cloete, E, Gentles, TL |
| Zdroj: |
Archives of Disease in Childhood; 2018, Vol. 103 Issue: Supplement 1 pA102-A102, 1p |
| Abstrakt: |
IntroductionIsolated reports from selected populations suggest early diagnosis in readily treatable critical congenital heart disease (cCHD) result in improved outcome, especially where the surgical outcome is excellent.However, population-based data are sparse and its interpretation complicated by inclusion of complex heart disease and noncardiac comorbidity that may independently influence outcome.AimCompare the outcome of infants born with critical CHD (CHD resulting in operation or death by 30 days) and likely resultant two-ventricle circulation from those born 2006–2010 with 2011–2014, in relation to antenatal diagnosis and 30 day mortality.MethodsA population-based retrospective review of critical CHD, with case ascertainment via the National Fetal Cardiology, the Cardiac Surgical and Governmental mortality review databases.ResultsOf the 436 infants born with critical CHD and a potential 2 ventricle circulation, 371 did not have a major non-cardiac abnormality or syndrome.The proportion of critical CHD’s diagnosed antenatally increased during the study period (p=0.006).The 30 day mortality declined from 7.0% to 0.9% (p=0.049).Mortality was largely confined to those who died prior to surgery.ConclusionsThere has been a significant increase in the rate of antenatal diagnosis in infants with readily treatable critical CHD.This has been an associated a decrease in the 30 day mortality.Earlier recognition of cCHD resulting in appropriate delivery location and a reduced risk of circulatory collapse has very likely contributed to the improved survival. |
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