Cardiac anomalies in children with congenital duodenal obstruction: a systematic review with meta-analysis

Abstract

Background Cardiac anomalies occur frequently in patients with congenital duodenal obstruction (DO). However, the exact occurrence and the type of associated anomalies remain unknown. Therefore, the aim of this systematic review is to aggregate the available literatures on cardiac anomalies in patients with DO. Methods In July 2022, a search was performed in PubMed and Embase.com. Studies describing cardiac anomalies in patients with congenital DO were considered eligible. Primary outcome was the pooled percentage of cardiac anomalies in patients with DO. Secondary outcomes were the pooled percentages of the types of cardiac anomalies, type of DO, and trisomy 21. A meta-analysis was performed to pool the reported data. Results In total, 99 publications met our eligibility data, representing 6725 patients. The pooled percentage of cardiac anomalies was 29% (95% CI 0.26–0.32). The most common cardiac anomalies were persistent foramen ovale 35% (95% CI 0.20–0.54), ventricular septal defect 33% (95% CI 0.24–0.43), and atrial septal defect 33% (95% CI 0.26–0.41). The most prevalent type of obstruction was type 3 (complete atresias), with a pooled percentage of 54% (95% CI 0.48–0.60). The pooled percentage of Trisomy 21 in patients with DO was 28% (95% CI 0.26–0.31). Conclusion This review shows cardiac anomalies are found in one-third of the patients with DO regardless of the presence of trisomy 21. Therefore, we recommend that patients with DO should receive preoperative cardiac screening. Level of evidence II.

Duodenal Atresia in Finland from 2004 to 2017: Prevalence, Mortality, and Associated Anomalies—A Population-Based Study

“…We also found most structural anomalies to be cardiac. The rate in this study was 36% which is in line with Pijpers et al, who report cardiac defects in nearly one third of DA patients, 9,11 although rates as low as 12% in DA have previously been reported. 5 This apparent increase is likely due to the improvements in echocardiography technology.…”

“…5,[8][9][10] From congenital structural anomalies, cardiac defects are the most common as represented approximately in 30% of the cases, and together with trisomy 21, the rate rises up to 60%. 11 Other co-occurring anomalies include other gastrointestinal anomalies like esophageal atresia or anorectal malformation as well as genitourinary malformations. 1,8 Associated intestinal atresias as well as biliary duct anomalies are rare.…”