Echocardiographic findings in newborns and postneonatal infants undergoing preoperative evaluation for surgically correctable non-cardiac congenital malformations

Abstract

Background: Congenital cardiac malformations could co-exist with surgically correctable non-cardiac congenital structural abnormalities. The occurrence of the two conditions portends increased anaesthetic risk and perioperative complications. Early recognition could favourably alter the post-operative outcome.

Objectives: To describe the prevalence and pattern of congenital heart defects in young infants with extracardiac structural malformations.

Methods: Consecutive newborns and postneonatal infants with congenital malformations being prepared for surgery were sent to the paediatric cardiology unit of University of Abuja Teaching Hospital for echocardiography and were recruited over a 30 moth period. A transthoracic echocardiography, following the guidelines of the American Society of Echocardiography, was used to evaluate the cardiac structures.

Results: Of the 44 newborns and postneonatal infants with congenital non-cardiac malformations, 27 (61.4%) were males while 17 (38.6%) were females, giving a M:F ratio of 1.59:1. Gastrointestinal malformations constituted 47.7% of cases. Omphalocoele major and biliary atresias were the most common malformations seen. Seven babies had completely normal heart, five had isolated patent foramen ovale, thus giving a total of 12 babies with structurally normal hearts. Of the 32 babies with structural heart defects, 17 (53.1%) had single defect while 15 (46.9%) had two or more defects consisting of 26 acyanotic and 4 cyanotic defects. A total of 47 cardiac defects were seen. Forty-two (89.4%) of the heart defects were simple while 5(10.6%) were complex. Atrial septal defect 13,(27.7%), patent ductus arteriosus 14, (29.8%) and ventricular septal defect 7,(14.9%) were the commonest simple heart defects while atrioventricular septal defects predominate among the complex category

Conclusions: Congenital structural abnormalities are common indications for surgical interventions in young infants. Recognition of co- existing structural cardiac abnormalities is essential in preoperative planning and may be a useful guide in averting untoward anaesthetic accident.