Congenital heart defects in children with cleft lips and/or palates at an academic hospital in central South Africa
| Autor: | B J S Diedericks, Edwin Turton, W J Barrett, Gina Joubert, C.L. Barrett |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
0301 basic medicine
Pediatrics medicine.medical_specialty medicine.diagnostic_test business.industry Physical examination 030230 surgery 030105 genetics & heredity medicine.disease Preoperative care Lesion 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine congenital heart defects cleft deformities cleft lip cleft palate cleft lip with or without cleft palate medicine Deformity National registry medicine.symptom Craniofacial business Congenital heart defects in children Cardiac lesion |
| Zdroj: | Southern African Journal of Anaesthesia and Analgesia; Vol. 25 No. 2 (2019); 23-29 |
| ISSN: | 2220-1181 2220-1173 |
| Popis: | Background: Globally, cleft deformities are the most common craniofacial anomalies and show an association with congenital heart defects. Little research on cleft lips and/or palates (CL/P) and congenital heart defects has been reported from Africa, and none from South Africa. In 2001, it was proposed that CL/P be listed as one of six priority conditions for monitoring and notification to South African health authorities. This goal of creating a national registry has not been achieved. A near-fatal anaesthetic incident following a missed cardiac lesion in a child with a cleft lip and palate prompted this study. Objectives: To describe the prevalence of congenital heart defects diagnosed in children with CL/P presenting for corrective surgery during the Smile Week over three consecutive years (2013–2015) at an academic hospital in South Africa. Methods: A retrospective, descriptive file review of 62 patients with CL/P was performed. Since 2013, echocardiography has been performed on all patients with CL/P. Results: Twenty-three, 21 and 18 patients were operated in 2013, 2014 and 2015, respectively. Of these patients, 85.5% (n = 53) had no clinical evidence of a cardiac defect, of which eight did have clinically significant cardiac defects on echocardiography. Sixteen patients (25.8%) in total (n = 16/62) with a cleft deformity had a clinically significant congenital heart lesion. Of the 16 patients with a cardiac defect on transthoracic echocardiography, only four had clinical evidence of cardiac defect. Therefore, sensitivity of clinical examination was 25%, whereas the specificity was 89.1%. Three of the four patients with a syndrome had a clinically significant echocardiographic finding. Conclusion: A national guideline for the preoperative care of patients with CL/P, including routine echocardiography, is needed. Furthermore, a national registry is required for patients with CL/P with associated congenital anomalies. |
| Databáze: | OpenAIRE |
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