Ko Jung Min
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
Korean Circ J. 2015 Sep;45(5):357-61. doi: 10.4070/kcj.2015.45.5.357. Epub 2015 Jul 7.
Recent research has demonstrated that genetic alterations or variations contribute considerably to the development of congenital heart disease. Many kinds of genetic tests are commercially available, and more are currently under development. Congenital heart disease is frequently accompanied by genetic syndromes showing both cardiac and extra-cardiac anomalies. Congenital heart disease is the leading cause of birth defects, and is an important cause of morbidity and mortality during infancy and childhood. This review introduces common genetic syndromes showing various types of congenital heart disease, including Down syndrome, Turner syndrome, 22q11 deletion syndrome, Williams syndrome, and Noonan syndrome. Although surgical techniques and perioperative care have improved substantially, patients with genetic syndromes may be at an increased risk of death or major complications associated with surgery. Therefore, risk management based on an accurate genetic diagnosis is necessary in order to effectively plan the surgical and medical management and follow-up for these patients. In addition, multidisciplinary approaches and care for the combined extra-cardiac anomalies may help to reduce mortality and morbidity accompanied with congenital heart disease.
最近的研究表明,基因改变或变异在先天性心脏病的发生发展过程中起着相当大的作用。市面上有多种基因检测可供选择,目前还有更多检测正在研发中。先天性心脏病常伴有显示心脏和心脏外异常的基因综合征。先天性心脏病是出生缺陷的主要原因,也是婴儿期和儿童期发病和死亡的重要原因。本综述介绍了显示各种类型先天性心脏病的常见基因综合征,包括唐氏综合征、特纳综合征、22q11缺失综合征、威廉姆斯综合征和努南综合征。尽管手术技术和围手术期护理有了显著改善,但患有基因综合征的患者手术相关死亡或重大并发症的风险可能会增加。因此,为了有效地规划这些患者的手术、医疗管理和随访,基于准确基因诊断的风险管理是必要的。此外,针对合并的心脏外异常的多学科方法和护理可能有助于降低先天性心脏病伴发的死亡率和发病率。