Department of Pediatric Cardiology, Istituto Giannina Gaslini , Genoa , Italy.
Department of Pediatric Surgery, Istituto Giannina Gaslini , Genoa , Italy.
Front Pediatr. 2014 Sep 17;2:99. doi: 10.3389/fped.2014.00099. eCollection 2014.
To define the prevalence and characteristics of associated congenital heart diseases (CHDs) in patients with Hirschsprung's disease (HSCR).
All patients with a histological diagnosis of HSCR admitted to our hospital between January 2010 and December 2013 were included in this prospective observational study and underwent cardiovascular screening. Cardiac anatomy was assessed by a segmental echocardiographic approach. Measurements of aortic root and left ventricular dimensions, wall thickness, and function were obtained. CHDs requiring a percutaneous or surgical intervention were described as major heart diseases.
One hundred thirty-three consecutive patients were enrolled at median age of 2.3 years. Eleven patients (8.3%) presented an associated heart disease. Moreover, five patients had mild dilatation of aortic root. Six out of 11 (4.5%) patients had a major CHDs requiring surgical repair.
Prevalence of associated CHDs was slightly higher than in previous papers, and mostly represented by septal defects. Four out of six patients with major heart disease had also a chromosomal anomaly. If we do not consider the subpopulation of patients with a chromosomal anomaly, cardiac defects were present in 3.8% of the patients. Based on these results, we suggest to perform routine echocardiogram in all Hirschsprung patients, with or without associated chromosomal syndromes.
定义先天性心脏病(CHD)与先天性巨结肠(HSCR)相关的患病率和特征。
本前瞻性观察研究纳入了 2010 年 1 月至 2013 年 12 月期间在我院接受组织学诊断为 HSCR 的所有患者,并对其进行心血管筛查。采用节段性超声心动图方法评估心脏解剖结构。测量主动脉根部和左心室的尺寸、壁厚度和功能。需要经皮或手术干预的 CHD 被描述为主要心脏病。
133 例连续患者的中位年龄为 2.3 岁。11 例(8.3%)患者存在相关心脏病。此外,5 例患者的主动脉根部有轻度扩张。11 例患者中有 6 例(4.5%)存在需要手术修复的主要 CHD。
与先天性心脏病相关的患病率略高于以往的研究,主要表现为间隔缺损。6 例主要心脏病患者中有 4 例也存在染色体异常。如果我们不考虑伴有染色体异常的患者亚群,那么患有心脏缺陷的患者占 3.8%。基于这些结果,我们建议对所有伴有或不伴有相关染色体综合征的先天性巨结肠患者进行常规超声心动图检查。