Safety and Efficacy of Surgical and Percutaneous Cardiac Interventions for Adults With Down Syndrome

Mayo Clinic proceedings. Innovations, quality & outcomes Pub Date : 2023-12-26 DOI:10.1016/j.mayocpiqo.2023.11.002

Kaitlin Roehl PA-C , Carolyn Mead-Harvey MS , Heidi M. Connolly MD , Joseph A. Dearani MD , Felicia S. Schaap APRN, AGACNP-BC , Susanna L. Liljenstolpe APRN, FNP-C , Linda B. Osborn RN , C. Charles Jain MD , Donald J. Hagler Sr. MD , Francois Marcotte MD , David S. Majdalany MD

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Abstract

Objective

To assess risks and benefits of cardiac intervention in adults with Down syndrome (DS).

Patients and Methods

A retrospective review was conducted using data from a study we published in 2010. Patients aged 18 years or older with DS who underwent cardiac operation or percutaneous intervention from February 2009 through April 2022 (new cohort) were compared with patients in the previous study (January 1969 through November 2007; remote cohort) at Mayo Clinic.

Results

In total, 81 adults (43 men; 38 women) with DS underwent 89 cardiac interventions (84 surgical; 5 percutaneous) at a mean age of 33 years. Twenty-six patients presented with complete atrioventricular canal defect (17%) or tetralogy of Fallot (15%). The most common adult procedures were valve interventions: mitral (31%), tricuspid (15%), and pulmonary (12%). Of pulmonary valve interventions in the new cohort, 33% were performed percutaneously. The postoperative mortality rate was low (1% total). The mean time between last operation and death was 16 years.

Conclusion

Adults with DS can undergo cardiac operation and percutaneous intervention with low morbidity and mortality risk and good long-term survival.

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手术和经皮心脏介入治疗唐氏综合征成人的安全性和有效性

目的评估唐氏综合征（DS）成人患者接受心脏介入治疗的风险和益处。患者和方法利用我们于 2010 年发表的一项研究的数据进行了回顾性研究。将 2009 年 2 月至 2022 年 4 月期间接受心脏手术或经皮介入治疗的 18 岁或以上 DS 患者（新队列）与梅奥诊所之前研究（1969 年 1 月至 2007 年 11 月；远程队列）中的患者进行比较。结果共有 81 名成人 DS 患者（43 名男性；38 名女性）接受了 89 次心脏介入治疗（84 次手术；5 次经皮），平均年龄为 33 岁。26名患者伴有完全性房室管缺损（17%）或法洛氏四联症（15%）。最常见的成人手术是瓣膜介入：二尖瓣（31%）、三尖瓣（15%）和肺动脉瓣（12%）。在新组群中，33%的肺动脉瓣介入手术是经皮进行的。术后死亡率很低（1%）。结论：DS成人可以接受心脏手术和经皮介入治疗，发病率和死亡率较低，长期存活率较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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