| Clinical Course of Atrioventricular Septal Defect(AVSD) in Down and non Down syndrome |
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Un Seok Nho, Myung Chul Hyun, Sang Bum Lee |
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Department of Pediatrics, Kyungpook National University, College of Medicine, Taegu, Korea |
| Down증후군과 비Down증후군에서 동반된 방실중격결손 (Atrioventricular septal defect)의 임상경과 |
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노은석, 현명철, 이상범 |
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경북대학교 의과대학 소아과학교실 |
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| Abstract |
Purpose
: It is well known that 1/3 - 1/2 of Atrioventricular septal defect(AVSD) patients also
have Down syndrome which may influence the clinical course of AVSD. To know the anatomic
type of AVSD and the effect of Down syndrome on the clinical course of AVSD, we studied
37 cases( Down group: 14 cases, non Down group: 23 cases) who were diagnosed and followed
at Department of Pediatrics, Kyungpook National University Hospital between Jan. 1987 and
Dec. 1994.
Methods
: Patients were diagnosed to have AVSD by 2D-echocardiography and Down
syndrome by chromosome study. In 17 cases we catheterizes, Qp/Qs, Rp/Rs and Pp/Ps were
compared according to the group. In 14 cases we operated on, the durations of ventilator
therapy, ICU stay, and hospital admission were also compared.
Results
: Of the 36 cases with AVSD, Down syndrome were 14 cases(38%). In Down
group(14 cases), complete type of AVSD were 6 cases(43%, Rastelli A: 4 cases, Rastelli B: 1,
Rastelli C: 1) and incomplete type of AVSD were 8 cases(57%, Atrial septal defect only: 4
cases, Ventricular septal defect only: 4). In non Down group(23 cases), complete type of AVSD
were 10 cases(42%, Rastelli A: 7 cases, Rastelli B: 2, Rastelli C: 1) and incomplete type of
AVSD were 13 cases(58%, Atrial septal defect only: 10 cases, Ventricular septal defect only: 3).
Of the 17 cases we catheterized(Down group: 9 cases, mean age: 2.1¡¾2.0 years, non Down
group: 8 cases, mean age: 2.7¡¾3.9 years), Qp/Qs was significantly high in non Down
group(1.42¡¾0.60 vs 2.61¡¾1.31, p<0.05) but Rp/Rs and Pp/Ps were significantly high in Down
group(Rp/Rs: 0.34¡¾0.31 vs 0.10¡¾0.06, Pp/Ps: 0.68¡¾0.28 vs 0.31¡¾0.09, P<0.05 respectively).
Of the 14 cases we operated on(Down group: 6 cases, non Down group: 8 cases), the
duration of ventilator therapy, ICU stay and hospital admission were not significantly different
between both groups but tended to be long in Down syndrome(ventilator therapy: 5.3¡¾2.5 days
vs 4.3¡¾6.7, ICU stay: 9.0¡¾6.1 days vs 3.0¡¾2.3, hospital admission: 29.4¡¾25.9 days vs
21.9¡¾27.4).
Conclusion
: Down syndrome may adversely influencd the course of atrioventricular septal
defect hemodynamically and clinically. |
| Key Words:
Atrioventricular septal defect, Down syndrome |
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