Abstract
The aim of the study is to explore the epidemiology of the coarctation of the aorta in newborn infants in Latvia, to analyze all the cases of aortic coarctations diagnosed and operated in our hospital within the first two months of human’s life in the period from January 1, 2005 to December 31, 2010, and to indicate the time of diagnosis and its relation to the condition of the patient at the moment of the admission, the course of the disease and the outcomes.
Materials and methods Retrospective analysis of the case histories of all the neonates and infants in the age group up to two months (n = 45) diagnosed the coarctation of the aorta and undergone surgical correction of the coarctation.
Results The prevalence of the coarctation of the aorta in the period of 2005−2010 was 0.41 ± 0.11 per 1000 live-born infants. We studied 45 babies, 14 newborns (31%) and 31 infant (69%). Our data show that 64% (n = 29) of the patients were sent by maternity hospitals but 36% (n = 16) after the discharge from the maternity hospital. The diagnoses of the referral were the coarctation or congenital heart disease suspected in 73% (n = 33), but other diagnoses (sepsis, pneumonia, feeding disturbances) suspected in 27% (n = 12) of the cases. In the study group there were 51% (n = 23) patients with isolated aortic coarctation, 29% (n = 13) in combination with VSD but 20% (n = 9) cases with complex coarctation. There was correlation between concomitant intracardiac pathology and antenatal diagnosis observed. The admission after the discharge from maternity hospital correlates with older age at the time of the operation, slightly higher rates of the need for inotropes and assisted ventilation but lower overall mortality rates in the group of delayed diagnosis although no statistically significant. The infants who left hospital undiagnosed had a much greater proportion of serious acidosis at the time of diagnosis (45%) than those diagnosed before the discharge from the maternity hospital (7%; p = 0.031).
Conclusions .The substantial number of unrecognized cases in prehospital stage are indicative of the need for further education for paediatricians and general practitioners working with neonates and small infants, because delayed diagnosis may carry worsened surgical outcomes and increased length of hospital stay.
Keywords: diagnosis, congenital heart disease, coarctation
Materials and methods Retrospective analysis of the case histories of all the neonates and infants in the age group up to two months (n = 45) diagnosed the coarctation of the aorta and undergone surgical correction of the coarctation.
Results The prevalence of the coarctation of the aorta in the period of 2005−2010 was 0.41 ± 0.11 per 1000 live-born infants. We studied 45 babies, 14 newborns (31%) and 31 infant (69%). Our data show that 64% (n = 29) of the patients were sent by maternity hospitals but 36% (n = 16) after the discharge from the maternity hospital. The diagnoses of the referral were the coarctation or congenital heart disease suspected in 73% (n = 33), but other diagnoses (sepsis, pneumonia, feeding disturbances) suspected in 27% (n = 12) of the cases. In the study group there were 51% (n = 23) patients with isolated aortic coarctation, 29% (n = 13) in combination with VSD but 20% (n = 9) cases with complex coarctation. There was correlation between concomitant intracardiac pathology and antenatal diagnosis observed. The admission after the discharge from maternity hospital correlates with older age at the time of the operation, slightly higher rates of the need for inotropes and assisted ventilation but lower overall mortality rates in the group of delayed diagnosis although no statistically significant. The infants who left hospital undiagnosed had a much greater proportion of serious acidosis at the time of diagnosis (45%) than those diagnosed before the discharge from the maternity hospital (7%; p = 0.031).
Conclusions .The substantial number of unrecognized cases in prehospital stage are indicative of the need for further education for paediatricians and general practitioners working with neonates and small infants, because delayed diagnosis may carry worsened surgical outcomes and increased length of hospital stay.
Keywords: diagnosis, congenital heart disease, coarctation
| Original language | English |
|---|---|
| Title of host publication | Rīga Stradiņš University Collection of Scientific Papers 2011 |
| Subtitle of host publication | Research articles in medicine & pharmacy |
| Place of Publication | Rīga |
| Publisher | Rīgas Stradiņa universitāte |
| Pages | 54-60 |
| Number of pages | 7 |
| ISBN (Print) | 978-9984-788-58-6 |
| Publication status | Published - 1 Jan 2012 |
Publication series
| Name | Collection of Scientific Papers |
|---|---|
| Publisher | Riga Stradins University |
| ISSN (Print) | 1691-497X |
Keywords*
- aortic coarctation
- infants
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.2. Articles or chapters in other proceedings other than those included in 3.1., with an ISBN or ISSN code