Heart Surgery
This is a complete listing of all publications related to cardiac surgery for children with trisomy 13 and 18. When surgery is offered to children whom doctors believe will have a reasonable chance of benefit, survival rates for those children have been shown to increase. Click the title for the link.
Maeda et al. 2011. Am J Med Genet Part A The impact of cardiac surgery in patients with trisomy 18 and trisomy 13 in Japan.
This article is a review of 134 children with trisomy 18, and 27 children with trisomy 13 from the Japanese Society of Pediatric Cardiology and Cardiac Surgery. Approximately 25% of the children had cardiac surgery. Survival was related to birth weight and gestational age.
Yates et al. 2011. J Genet Couns Pediatric sub-specialist controversies in the treatment of congenital heart disease in trisomy 13 or 18.
Between 2007 and 2008, 859 American pediatric sub-specialists including geneticists, neonatologists and cardiologists responded to a survey about their willingness to offer or provide cardiac surgery to children with trisomy 13 and 18. The results show that cardiologists were most willing to offer surgery and neonatologists were least likely. The authors conclude that parental requests for surgery have a major effect on whether or not surgery was offered.
ITA believes the finding of this paper highlights the importance of parents to be knowledgeable, active participants in their child’s care.
Muneuchi J. 2011. Cardiol Young Outcomes of cardiac surgery in trisomy 18 patients.
The authors described 34 Japanese children with trisomy 18. Some of the children were treated conservatively while others had cardiac surgery. The one year survival rates for the two groups were 9% and 25%, respectively. The authors conclude that some children can be helped with cardiac surgery.
Kobayashi et al.2010. Gen Thorac Cardiovasc Surg J, Radical surgery for a ventricular septal defect associated with trisomy.
Five female infants with trisomy 18 from Japan underwent full cardiac repair. All survived surgery and lived beyond 30 days with an average survival after surgery of 815 days. The authors conclude that cardiac surgery can be beneficial for some children with trisomy 18.
Kaneko. 2009. Pediatr Cardiol Cardiac surgery in patients with trisomy 18.
This Japanese study describes the outcome of 17 babies with trisomy 18 who received cardiac surgery. Fourteen of these surgeries were palliative (a temporary remedy) or banding surgery for VSD (full repair is necessary in the future for those that survive). Almost half survived beyond one year. Eighty-two percent of children were discharged home. The median post-operative survival time was 179 days (range 1-1239 days). From the time of publication of this article, six children were still living.
ITA cautions that the positive outcome of the in this study cannot be applied prospectively to all babies with trisomy 18 because the babies that were offered surgery in this study were only those whom were deemed by the neonatologist, cardiologist and surgeon to have a “reasonable probability” of being discharged home without a ventilator. No information is provided regarding other serious anomalies that some babies with trisomy 18 might have such as esophageal atresia and omphalocele. It is possible that the children who were offered surgery did not have these serious accompanying malformations.
Kaneko et al. 2008. Pediatrics Intensive cardiac management in patients with trisomy 13 or trisomy 18
This article reviewed the outcome of 31 consecutive Japanese infants with trisomy 13 or 18 born between 2000 and 2005. Some children were offered both medications and surgery for cardiac anomalies resulting in a significant increase in survival.
Graham et al. 2004. Am J Cadiol Effectiveness of cardiac surgery in trisomies 13 and 18 (from the Pediatric Cardiac Care Consortium).
This article reports on 35 cardiac surgeries performed at one of 48 reporting centers in the US, Canada and Europe. Eleven children with trisomy 13 had cardiac surgery at an average age 77 days and were discharged after an average of 11 days. All the children survived surgery. Twenty-four children with trisomy 18 had cardiac surgery at an average age of 145 days, were discharged after an average of 9 days, and 86% survived. Five of the surviving children were still ventilated at the time of discharge but 26 children were removed from life support less than two days after surgery.
ITA believes that it is likely the children in this article were offered surgery because their providers deemed that they had a reasonable probability of benefit. Parents should be cautious to apply the results prospectively. Every child is unique and needs to be assessed individually to determine if curative surgery is in their best interest.
This article is a review of 134 children with trisomy 18, and 27 children with trisomy 13 from the Japanese Society of Pediatric Cardiology and Cardiac Surgery. Approximately 25% of the children had cardiac surgery. Survival was related to birth weight and gestational age.
Yates et al. 2011. J Genet Couns Pediatric sub-specialist controversies in the treatment of congenital heart disease in trisomy 13 or 18.
Between 2007 and 2008, 859 American pediatric sub-specialists including geneticists, neonatologists and cardiologists responded to a survey about their willingness to offer or provide cardiac surgery to children with trisomy 13 and 18. The results show that cardiologists were most willing to offer surgery and neonatologists were least likely. The authors conclude that parental requests for surgery have a major effect on whether or not surgery was offered.
ITA believes the finding of this paper highlights the importance of parents to be knowledgeable, active participants in their child’s care.
Muneuchi J. 2011. Cardiol Young Outcomes of cardiac surgery in trisomy 18 patients.
The authors described 34 Japanese children with trisomy 18. Some of the children were treated conservatively while others had cardiac surgery. The one year survival rates for the two groups were 9% and 25%, respectively. The authors conclude that some children can be helped with cardiac surgery.
Kobayashi et al.2010. Gen Thorac Cardiovasc Surg J, Radical surgery for a ventricular septal defect associated with trisomy.
Five female infants with trisomy 18 from Japan underwent full cardiac repair. All survived surgery and lived beyond 30 days with an average survival after surgery of 815 days. The authors conclude that cardiac surgery can be beneficial for some children with trisomy 18.
Kaneko. 2009. Pediatr Cardiol Cardiac surgery in patients with trisomy 18.
This Japanese study describes the outcome of 17 babies with trisomy 18 who received cardiac surgery. Fourteen of these surgeries were palliative (a temporary remedy) or banding surgery for VSD (full repair is necessary in the future for those that survive). Almost half survived beyond one year. Eighty-two percent of children were discharged home. The median post-operative survival time was 179 days (range 1-1239 days). From the time of publication of this article, six children were still living.
ITA cautions that the positive outcome of the in this study cannot be applied prospectively to all babies with trisomy 18 because the babies that were offered surgery in this study were only those whom were deemed by the neonatologist, cardiologist and surgeon to have a “reasonable probability” of being discharged home without a ventilator. No information is provided regarding other serious anomalies that some babies with trisomy 18 might have such as esophageal atresia and omphalocele. It is possible that the children who were offered surgery did not have these serious accompanying malformations.
Kaneko et al. 2008. Pediatrics Intensive cardiac management in patients with trisomy 13 or trisomy 18
This article reviewed the outcome of 31 consecutive Japanese infants with trisomy 13 or 18 born between 2000 and 2005. Some children were offered both medications and surgery for cardiac anomalies resulting in a significant increase in survival.
Graham et al. 2004. Am J Cadiol Effectiveness of cardiac surgery in trisomies 13 and 18 (from the Pediatric Cardiac Care Consortium).
This article reports on 35 cardiac surgeries performed at one of 48 reporting centers in the US, Canada and Europe. Eleven children with trisomy 13 had cardiac surgery at an average age 77 days and were discharged after an average of 11 days. All the children survived surgery. Twenty-four children with trisomy 18 had cardiac surgery at an average age of 145 days, were discharged after an average of 9 days, and 86% survived. Five of the surviving children were still ventilated at the time of discharge but 26 children were removed from life support less than two days after surgery.
ITA believes that it is likely the children in this article were offered surgery because their providers deemed that they had a reasonable probability of benefit. Parents should be cautious to apply the results prospectively. Every child is unique and needs to be assessed individually to determine if curative surgery is in their best interest.
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