Department of Pediatrics and Neonatology, Mongi Slim Hospital, La Marsa, Tunis, Tunisia. University of Tunis el Manar Faculty of Medicine of Tunis.
Tunis Med. 2024 Sep 5;102(9):576-581. doi: 10.62438/tunismed.v102i9.5060.
Congenital heart disease is a heterogeneous group of malformations and one of the most common causes of mortality in children.
The aim of this study was to investigate the clinical, genetic and evolutive characteristics of congenital heart disease.
A retrospective, descriptive study was carried out between 2020 and 2023 at the pediatrics and neonatology department of Mongi Slim university hospital of Tunis. All children with confirmed congenital heart disease were included.
Forty-five patients were included, representing 5.7‰ of all admissions. The sex ratio was 1.4. A prenatal diagnosis of congenital heart disease was established in 9% of cases. The median age at the time of discovery was 18 days. The initial symptomatology was respiratory distress in 64% of cases. The main reasons for performing a cardiac ultrasound were heart murmur in 38% followed by polymalformative assessment in 27% of cases. Most of the cardiopathies were atrial septal defects (42%) and ventricular septal defects (40%). Cyanotic heart diseases represented 29% of cases, conotruncal ones 13% and ductodependent ones 16%. Congenital heart disease was associated with a genetic anomaly in 53% of patients, including 15 cases of trisomy 21 and four Di-George syndromes. The treatment was mainly medical (38%), associated with surgery in 5 cases. Death occurred in nine patients, representing a mortality rate of 20%.
Efforts still need to be made to improve pre- and post-natal diagnosis and ensure rapid treatment in order to reduce morbidity and mortality in our country.
先天性心脏病是一组异质性畸形,也是儿童死亡的最常见原因之一。
本研究旨在探讨先天性心脏病的临床、遗传和演变特征。
这是一项在突尼斯蒙吉斯利姆大学医院儿科和新生儿科进行的回顾性描述性研究,研究时间为 2020 年至 2023 年。所有确诊为先天性心脏病的儿童均被纳入研究。
共纳入 45 例患者,占所有入院患者的 5.7‰。男女比例为 1.4。9%的病例在产前诊断出先天性心脏病。发现时的中位年龄为 18 天。首发症状为呼吸困难,占 64%。进行心脏超声检查的主要原因是心脏杂音,占 38%,其次是多畸形评估,占 27%。大多数心脏畸形为房间隔缺损(42%)和室间隔缺损(40%)。紫绀性心脏病占 29%,圆锥动脉干畸形占 13%,导管依赖性心脏病占 16%。先天性心脏病与 53%的患者的遗传异常相关,包括 15 例 21 三体和 4 例 DiGeorge 综合征。治疗主要为药物治疗(38%),5 例患者接受了手术治疗。9 例患者死亡,死亡率为 20%。
仍需努力提高产前和产后诊断水平,并确保快速治疗,以降低我国的发病率和死亡率。