Document Detail


Fetal and post-natal diagnosis of major congenital heart disease: Implications for medical and psychological care in the current era.
MedLine Citation:
PMID:  21449901     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aim:  The fetal or post-natal diagnosis of major congenital cardiac abnormality has important medical and psychological consequences. Methods:  We reviewed infants who underwent cardiac surgery in the first year of life at the Heart Centre for Children, The Children's Hospital at Westmead during 2009. The aims of this study were to: (i) examine the key features of cardiac diagnosis and clinical outcome, and (ii) consider how these data can inform priorities for the delivery of clinical services. Results:  Over the 12-month study period, a first cardiac surgical procedure was performed on 195 infants, with 85 infants (44%) diagnosed in the antenatal period. Of the total sample, a subset of 90 babies (46%) underwent their first procedure in the neonatal period, with 62% having had a fetal diagnosis. Major intracardiac lesions including truncus arteriosus (100%), single ventricular lesions (83%), pulmonary atresia with ventricular septal defect (78%) and transposition of the great arteries (53%) were diagnosed prior to birth. Improved haemodynamic stability at initial presentation was found in those with a fetal diagnosis. The overall mortality rate for all patients was 6.1% at 12 months, with a higher mortality in infants with single ventricle. Conclusions:  The contemporary paradigm of care for infants with major congenital heart disease requires a multidisciplinary approach to care, with improvements in clinician-clinician and clinician-family communication, and psychological support and education for families. Changes in the allocation of resources are required to meet this model of best practice.
Authors:
Gary F Sholler; Nadine A Kasparian; Victoria E Pye; Andrew D Cole; David S Winlaw
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-30
Journal Detail:
Title:  Journal of paediatrics and child health     Volume:  -     ISSN:  1440-1754     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9005421     Medline TA:  J Paediatr Child Health     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
Affiliation:
Heart Centre for Children, The Children's Hospital at Westmead, Westmead Sydney Medical School, The University of Sydney, Sydney School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia.
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