Key result
Down syndrome is linked to late CAVC referral in ~36% of cases, precluding surgery.
Why the study?
Some children with Down's syndrome and complete atrioventricular canal defect are being denied standard cardiac care due to late referral despite the severity of their condition.
Does Down's syndrome affect the timing of referral and subsequent operability in children with complete atrioventricular canal defect?
Observational (n=36)
No
Does Down's syndrome affect the timing of referral and subsequent operability in children with complete atrioventricular canal defect?
Children with Down's syndrome and CAVC are at high risk of becoming inoperable due to PVOD as a result of delayed referral for cardiac care.
Answers are grounded in this paper and cite their sources.
Late referral linked to inoperability in Down syndrome with AV canal defect; leaves open whether earlier screening improves operability.
We reviewed the course of all 36 new patients with complete atrioventricular canal defect (CAVC) seen in a regional center from 1977 through 1982. Of this group of 36 patients, 28 had Down's syndrome. The eight children without Down's syndrome were all referred before 1 year of age. Surgical intervention was possible for each child. Of the 28 with Down's syndrome, 18 were referred before 1 year of age. Surgery intervention was possible in 17 (94%) of 18. Of the ten children with Down's syndrome referred after 1 year of age, surgical therapy was not possible in five because of pulmonary vascular obstructive disease (PVOD). Since CAVC is known to progress to PVOD at an early age, it is not surprising that half of those patients referred after 1 year of age had become inoperable because of this complication. We therefore concluded that in spite of the severity of CAVC some children with Down's syndrome and this heart condition are being denied standard cardiac care by the process of late referral.
No takes yet. Share an insight, caveat, or question.
Henry M. Sondheimer (1985) conducted an observational in Complete atrioventricular canal defect (CAVC) (n=36). Down's syndrome vs. Children without Down's syndrome was evaluated on Referral after 1 year of age. Children with Down's syndrome and complete atrioventricular canal defect experienced late referral (>1 year of age) in 35.7% of cases versus 0% without Down's syndrome, resulting in inoperability.
Synapse has enriched 10 related papers. Consider them for comparative context: