Abstract
BACKGROUND: Children with Down syndrome (DS) are reported to have a 40 to 50% incidence of congenital heart disease (CHD). In Saudi Arabia, there are few publications reporting outcomes of surgery for congenital heart disease in children with DS. We report a cohort of patients with DS who underwent corrective or palliative cardiac operations in Madinah Cardiac Center (MCC) in the last 4 years.
METHODS: All children with Down syndrome who underwent cardiac surgery in Madinah Cardiac Center from August 2013 to March 2018 were included. The clinical outcomes were analyzed based on complexity according to the risk adjustment for congenital heart surgery, i.e., the RACHS-1 method.
RESULTS: During this period, 565 children had cardiac operations in MCC. Eighty-nine had DS (16% of all cases). Of the patients with Down syndrome. 39% were offspring of consanguineous marriages, 16% had a family history of congenital heart disease, 2.24% had a family history of Down syndrome, and 27% had associated noncardiac anomalies. Based on risk category, the percentages of patients in RACHS 1 was 9%, RACHS 2 was 29%, RACHS 3 was 61%, and RAC I IS 4 was only 1.12%. The overall mortality was 2.32%.
CONCLUSIONS: All patients with Down syndrome undergoing cardiac operations at MCC had acceptable outcomes, based on RACHS categories. Postoperative morbidity was low in our analysis. Surgical outcomes in children with DS with congenital heart disease were acceptable in all RACHS categories.