Adults with Down syndrome: safety and long-term outcome of cardiac operation.

Abstract

OBJECTIVE:

As limited data exist, we sought to review the safety and outcome of cardiac surgery in the adult Down syndrome population.

DESIGN:

We reviewed the data of all patients >or=18 years old with Down syndrome who underwent cardiac surgery (1969-2008) at our hospital.

RESULTS:

Fifty patients underwent 57 surgeries (mean age 33 years). Fifteen patients had prior cardiac operations in childhood: 7 complete and 1 partial atrioventricular canal, 2 secundum atrial septal defect, 2 Tetralogy of Fallot, 1 patent ductus arteriosus, 1 combined atrioventricular canal and Tetralogy of Fallot, and 1 ventricular septal defect. Operations in adult Down syndrome patients included repair of partial atrioventricular canal in 17, aortic valve replacement in 7, mitral valve replacement/repair in 7, ventricular septal defect in 6, atrial septal defect in 3, Tetralogy of Fallot in 3, pulmonary valve replacement in 3, and other in 11. There was 1 in-hospital death (1.8%) from multiorgan failure. The mean hospital stay was 10.6 days. Average ventilatory support was 2.4 days (range 0-32). Atrial arrhythmias occurred in 14 patients (25%). Six patients had early postoperative pulmonary infections. Mean follow-up was 6 years, maximum 29 years. There were eight late deaths at an average age of 52 years (range 30-58) occurring 15 years postoperatively (range 32 days-29 years); two in the setting of dementia (mean age 56 years).

CONCLUSION:

At an experienced center, adult patients with Down syndrome can undergo cardiac surgery with a low risk of mortality and acceptable morbidity. Atrial arrhythmias and pulmonary infections are common postoperatively.

• Authors: David S Majdalany, Harold M Burkhart, Heidi M Connolly, Martin D Abel, Joseph A Dearani, Carole A Warnes, Hartzell V Schaff
• Journal: Congenital heart disease (Congenit Heart Dis) Vol. 5 Issue 1 Pg. 38-43 ( 2010) ISSN: 1747-0803 [Electronic] United States
• PMID: 20136856 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Arrhythmias, Cardiac (etiology)
• Cardiac Surgical Procedures (adverse effects, mortality)
• Down Syndrome (complications, mortality)
• Female
• Heart Defects, Congenital (complications, mortality, surgery)
• Hospital Mortality
• Humans
• Length of Stay
• Male
• Middle Aged
• Respiration, Artificial
• Respiratory Tract Infections (etiology)
• Retrospective Studies
• Risk Assessment
• Time Factors
• Treatment Outcome
• Young Adult