About My Health Careers Internship MedBlogs Contact us
Medindia LOGIN REGISTER
Advertisement

Heart Surgery Benefits Infants With Trisomy 13 or 18

by Anjali Aryamvally on October 19, 2017 at 1:21 PM
Font : A-A+

Heart Surgery Benefits Infants With Trisomy 13 or 18

Heart surgery, although not part of standard medical care for trisomy 13 or 18 infants, it significantly decreases in-hospital mortality among them, reports study. These two genetic disorders cause severe physical and intellectual disabilities and the life expectancy is low. The study was conducted by a researcher at the Stanford University School of Medicine and his colleagues at the University of Arkansas for Medical Sciences.

Trisomy 13 and 18, which result from having extra chromosomes, often cause heart defects. Infants with the conditions generally die within their first year. Many die within weeks, if not days, of being born.

Advertisement


Due to these infants' short life expectancy, their heart conditions are often treated with standard medical care -- blood pressure medication, ventilators and intravenous fluids -- but not surgery. Many hospitals rarely give parents the option of surgery for their child. "The thought has been it doesn't make sense to undertake a major heart surgery if the patient's death within a few months is a near certainty," said Thomas Collins, MD, clinical associate professor of pediatric cardiology at the Stanford University School of Medicine.

But Collins and his co-authors at the University of Arkansas for Medical Sciences analyzed the outcomes of the 100 babies with trisomy 13 or 18 in the study who had received heart surgery, and recorded the health impacts. What they found was that patients who underwent heart surgery had a significant decrease in mortality, and that the impact lasted for the next two years. "We thought we'd show no difference in survival, but it turns out there's a marked one," Collins said.
Advertisement

A study describing the team's findings are published in Pediatrics. Collins, the senior author, was on the faculty of the University of Arkansas for Medical Sciences when much of the work was done. The lead author is Katherine Kosiv, MD, a cardiology fellow at the university.

Largest study of its kind

Using data gathered from 44 children's hospitals across the United States between 2004 and 2015, the researchers reported outcomes for nearly 1,600 patients, the largest study ever of infants with trisomy 13, also known as Patau syndrome, or trisomy 18, also known as Edwards syndrome, Collins said.

The researchers found that heart surgery increased survival and hospital discharge on average from 33 percent to approximately 67 percent for these patients, and that this benefit lasted through two years of follow-up. "When we analyzed the survival curves, the data spoke for themselves," Collins said. "Especially for trisomy 18, the number of babies that survive more than doubles after surgery."

Most infants in the study were admitted at less than a day old, and 51 percent of infants in the study who had congenital heart defects died in the hospital or were discharged to hospice. The researchers also found that in-hospital mortality decreased in infants who were older at their admission date, heavier and female, corroborating previous findings.

Challenging the narrative

Collins said his goal is to challenge the narrative surrounding these two conditions, much like how the story of trisomy 21, or Down syndrome, has changed in the last 40 years.

"Back in 1975, folks would've said there's nothing we can do to help those babies," he said. "But now people have proven if you do heart surgery early, patients with Down syndrome can live to adulthood and be active members of their community. The difference it makes for them is tremendous." Forty percent of people with Down syndrome have congenital heart disease, Collins said. And unlike cases of trisomy 13 and 18, it is now standard-of-care to operate on children with Down syndrome.

Scientists aren't sure why trisomy 13 and 18 are associated with higher rates of congenital heart disease than trisomy 21, and why patient death rates are so much higher.

Collins is certain, however, that trisomy 13 and 18 patients have far more neurological and developmental issues than those with Down syndrome, and is unsurprised at hospitals' attitudes that surgery is considered a big risk to take with patients who have a low likelihood of survival anyway.

Still, he suspects that the results of this study might shift the paradigm of how babies with trisomy 13 and 18 are cared for. "Surgery gives parents the option to say, 'We're going to do everything we can for our baby,'' said Collins. "And, now we've shown that heart surgeries could allow parents to take their babies home from the hospital, and have them for two years or beyond, as opposed to two weeks."

Collins also said that taking care of the patients' heart problems early on could enable caregivers to then properly analyze other health issues and perform follow-up procedures, such as tracheotomies, to improve the infants' respiration. His next study, in fact, is looking at all the risk factors other than heart disease in more than 3,000 trisomy 13 and 18 patients and analyzing how their collective health problems fit together. Collins hopes eventually to create a guideline for pediatric caregivers to determine which problems to treat in which order.

His work teasing out the most effective treatments for these babies ties into Stanford Medicine's focus on precision health, the goal of which is to anticipate and prevent disease in the healthy and precisely diagnose and treat disease in the ill.



Source: Eurekalert
Advertisement

Advertisement
News A-Z
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Advertisement
News Category
What's New on Medindia
Top 7 Benefits of Good Oral Hygiene
Healthy and Safer Thanksgiving 2021
Long-Term Glycemic Control - A Better Measure of COVID-19 Severity
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
Amoebic Dysentery Coronary Artery Bypass Grafting Mitral valve Regurgitation and Mitral valve Replacement Heart Healthy Heart Statins Mitral Valve Prolapse Aortic Valve Stenosis Pericarditis Cardiopulmonary Bypass 

Recommended Reading
Research Says Children With Trisomy 13 and 18 and Their Families Are Happy
Contrary to depression predictions made by doctors, children who are disabled with trisomy 13 or 18 ...
Researchers Develop Noninvasive Test for Trisomy 21
Research indicates that in 1980 in the United States, approximately 4.5% of all pregnant women were ...
Down Syndrome: Extra Little Chromosome Which Throws Entire Genome Off Balance
Down syndrome, also known as trisomy 21, is one of the most common cause of intellectual disability ...
New Path to Understanding Down Syndrome Following Gene-silencing Strategy
Research has shown the first evidence that the underlying genetic defect responsible for trisomy ......
Amoebic Dysentery
Amoebic dysentery or amoebiasis is an infection of the intestine that causes diarrhoea most frequent...
Aortic Valve Stenosis
Aortic valve Stenosis is an abnormal narrowing of the c valve. Symptoms include angina, and that of ...
Cardiopulmonary Bypass
Cardiopulmonary bypass is a technique which allows performing open heart surgical procedures in a bl...
Coronary Artery Bypass Grafting
Coronary artery bypass grafting (CABG) or heart bypass surgery is an open heart surgery to relieve t...
Mitral Valve Prolapse
Mitral Valve Prolapse is a relatively common condition and causes leakage of blood through the valve...
Mitral Valve Regurgitation and Mitral Valve Replacement
Mitral valve replacement is replacing the diseased mitral valve with an artificial valve....
Pericarditis
Pericarditis occurs when the pericardium gets inflamed. Pericarditis is characterized by severe ches...
Statins
Statins are new wonder drugs that are proving to be efficacious, not merely in relieving symptoms bu...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2021

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use