Radical surgery for a ventricular septal defect associated with trisomy 18

Abstract

Closure of VSDs in patients with trisomy 18 was found feasible and was associated with extended survival.

A Contemporary, Single-Institutional Experience of Surgical Versus Expectant Management of Congenital Heart Disease in Trisomy 13 and 18 Patients

“…In addition, as the surgical strategies used for correction of CHD are not always curative, other interventions or additional surgeries are also not uncommon. A recent study reported that five female ES patients with VSD, the most common form of CHD in ES, were successfully managed with operative VSD closure; four of these five patients survived to hospital discharge [7]. Other studies have concluded that intense cardiac management and cardiac surgery in this patient population improved survival [5].…”

Erring on the Side of Life: Children with Rare Trisomy Conditions, Medical Interventions and Quality of Life

“…The authors do not recommend caesarean sections or surgery in the immediate postnatal period for newborns with t18. This is in the face of multiple reports such as those from Japan of children living past the age of one year with positive surgical outcomes [17][18][19]. In addition, at the present time, there is very little literature on developmental outcomes [20,21].…”

Cardiovascular surgery for congenital heart disease associated with trisomy 18

“…Because no well-defi ned criteria for heart surgery are available for patients with T18, physicians often experience diffi culty when determining whether heart surgery should be performed. In reports advocating surgical treatment of CHD for patients with T18, including that by Kobayashi et al in this issue, 6 authors have suggested that surgical treatment, when performed with full understanding of the disease by the parents and with their hope for improving their children's condition, may contribute to improving the life expectancy of patients, discharge from hospital, and improving the quality of life (QOL) of both patients and their family.…”

“…However, such reports remain scanty. A larger number of cases must be accumulated, as in the above-mentioned report by Kobayashi et al, 6 for development of guidelines for treating these patients.…”

“…As described in the report by Kobayashi et al, 6 technical diffi culties encountered when performing surgical treatment of CHD in patients with T18 are being overcome. However, the opinions of parents and families of patients should be strongly respected in determining whether such surgery should be performed.…”