Calderón-Colmenero Juan, Flores Aída, Ramírez Samuel, Patiño-Bahena Emilia, Zabal Carlos, García-Montes José Antonio, Rizo Sandra, Buendía Alfonso, Attie Fause
Instituto Nacional de Cardiología Ignacio Chávez, INCICH, Juan Badiano No. 1 Col. Sección XVI, Tlalpan, 14080 México, D.F.
Arch Cardiol Mex. 2004 Jan-Mar;74(1):39-44.
We made a retrospective study of patients with Down's syndrome that were surgically treated for correction or palliation for their congenital heart disease between january 1996 to december of the 2000 in the National Institute of Cardiology "Ignacio Chávez". We analyzed these variables: age at the surgical moment, sex, congenital heart defect, pulmonary arterial pressure, type of surgery, time of stay in the intensive care unit, complications and mortality. In this period they were surgically treated 37 patients. The mean age was of 2 years with 8 months with a range of 2 months to 17 years. The interventricular defect was the most frequent one (35%) and it was associated to persistent ductus arteriosus in the 61% of the cases. Six patients (16%) had atrioventricular septal defect, the half of them type A and other half type C of Rastelli classification. Twelve patients (32%) had one lesion persistent ductus arteriosus. Three patients had tetralogy of Fallot and two atrial septal defect. Pulmonary hypertension was found in 90% of the patients, in 23 was severe (62%), moderate in 5 and slight in 6 (16%). The surgical treatment was corrective in 89% patients and the average time of stay in intensive care unit was of 2.5 days. The most frequent complication was rhythm and conduction disorders, in 8 patients (22%), three with complete AV block and the mortality was of 8%. In the patients with Down's syndrome is important a complete clinical evaluation with an eye toward establishing an opportune surgical treatment.
我们对1996年1月至2000年12月期间在国家心脏病学研究所“伊格纳西奥·查韦斯”接受先天性心脏病矫正或姑息手术治疗的唐氏综合征患者进行了回顾性研究。我们分析了这些变量:手术时的年龄、性别、先天性心脏缺陷、肺动脉压、手术类型、在重症监护病房的停留时间、并发症和死亡率。在此期间,37例患者接受了手术治疗。平均年龄为2岁8个月,范围为2个月至17岁。室间隔缺损最为常见(35%),在61%的病例中与动脉导管未闭有关。6例患者(16%)患有房室间隔缺损,其中一半为A 型,另一半为Rastelli分类的C型。12例患者(32%)患有动脉导管未闭这一病变。3例患者患有法洛四联症,2例患有房间隔缺损。90%的患者发现有肺动脉高压,其中23例严重(62%),5例中度,6例轻度(16%)。89%的患者接受了矫正性手术治疗,在重症监护病房的平均停留时间为2.5天。最常见的并发症是节律和传导障碍,8例患者(22%)出现,其中3例患有完全性房室传导阻滞,死亡率为8%。对于唐氏综合征患者,进行全面的临床评估以确定适时的手术治疗非常重要。