Children with transposition of the great arteries: Should they actually be born in Nigeria?
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摘要
AIMTo describe the clinical and echocardiographic features of Nigerian children with transposition of the great arteries and emphasize the need for collaboration with cardiac centres in the developed countries to be able to salvage the children.METHODS Prospective and cross sectional involving consecutive patients diagnosed with transposition of the great arteries using clinical evaluation and echocardiography at the Paediatric Department of Lagos State University Teaching Hospital,Lagos Nigeria as part of a large study between January 2007 and December 2015.RESULTS There were 51 cases of transposition of the great arteries within the study period with a male to female ratio of 2:1 and a prevalence of 1.55 per 10000among population of children who presented to centre during the study.Its proportion amongst children with congenital heart disease was 4.9%,while it was15.4%among those with cyanotic congenital heart disease.The mean age±SD of the subjects was 10.3±21.8 mo.Up to 70%of the patients were less than6 mo of age at initial presentation.The most common mode of presentation was cyanosis.The most common associated intracardiac anomaly was ventricular septal defect which occurred in 56%of the patients.CONCLUSION Transposition of the great arteries is as common in Nigeria as in the other parts of the world.The most common mode of presentation was cyanosis.There is an urgent need to establish paediatric cardiac centres in Nigeria if these children are to be salvaged.
AIMTo describe the clinical and echocardiographic features of Nigerian children with transposition of the great arteries and emphasize the need for collaboration with cardiac centres in the developed countries to be able to salvage the children.METHODS Prospective and cross sectional involving consecutive patients diagnosed with transposition of the great arteries using clinical evaluation and echocardiography at the Paediatric Department of Lagos State University Teaching Hospital,Lagos Nigeria as part of a large study between January 2007 and December 2015.RESULTS There were 51 cases of transposition of the great arteries within the study period with a male to female ratio of 2:1 and a prevalence of 1.55 per 10000among population of children who presented to centre during the study.Its proportion amongst children with congenital heart disease was 4.9%,while it was15.4%among those with cyanotic congenital heart disease.The mean age±SD of the subjects was 10.3±21.8 mo.Up to 70%of the patients were less than6 mo of age at initial presentation.The most common mode of presentation was cyanosis.The most common associated intracardiac anomaly was ventricular septal defect which occurred in 56%of the patients.CONCLUSION Transposition of the great arteries is as common in Nigeria as in the other parts of the world.The most common mode of presentation was cyanosis.There is an urgent need to establish paediatric cardiac centres in Nigeria if these children are to be salvaged.
AIMTo describe the clinical and echocardiographic features of Nigerian children with transposition of the great arteries and emphasize the need for collaboration with cardiac centres in the developed countries to be able to salvage the children.METHODS Prospective and cross sectional involving consecutive patients diagnosed with transposition of the great arteries using clinical evaluation and echocardiography at the Paediatric Department of Lagos State University Teaching Hospital,Lagos Nigeria as part of a large study between January 2007 and December 2015.RESULTS There were 51 cases of transposition of the great arteries within the study period with a male to female ratio of 2:1 and a prevalence of 1.55 per 10000among population of children who presented to centre during the study.Its proportion amongst children with congenital heart disease was 4.9%,while it was15.4%among those with cyanotic congenital heart disease.The mean age±SD of the subjects was 10.3±21.8 mo.Up to 70%of the patients were less than6 mo of age at initial presentation.The most common mode of presentation was cyanosis.The most common associated intracardiac anomaly was ventricular septal defect which occurred in 56%of the patients.CONCLUSION Transposition of the great arteries is as common in Nigeria as in the other parts of the world.The most common mode of presentation was cyanosis.There is an urgent need to establish paediatric cardiac centres in Nigeria if these children are to be salvaged.
引文
1 Maron BJ,Applefeld JM,Krovetz LJ.Racial frequencies in congenital heart disease.Circulation 1973;47:359-361[PMID:4684935 DOI:10.1161/01.CIR.47.2.359]
2 Botto LD,Correa A,Erickson JD.Racial and temporal variations in the prevalence of heart defects.Pediatrics 2001;107:E32[PMID:11230613 DOI:10.1542/PEDS.107.3.E32]
3 Fadero FF,Oyedeji OA,Aremu AA,Ogunkunle OO.Challenges in the management of congenital heart disease in contemporary Nigeria:An illustrative case of transposition of the great arteries.Nigerian J Pediat 2005;32:94-96
4 Adegboye VO,Omokhodion SI,Ogunkunle O,Brimmo AI,Adebo OA.Palliation for transposition of the great arteries.Nigerian JPediat 2003;5:129-133
5 Eze JC,Ezemba N.Open-heart surgery in Nigeria:indications and challenges.Tex Heart Inst J 2007;34:8-10[PMID:17420786]
6 Adebonojo SA.How viable are the cardiac programmes in West Africa today?In:Development of open heart surgery in West Africa;a historical perspective.Nigeria:Acecool Medical Publishers,2012:43-46
7 Charpie JR,Maher KO.Transposition of the great arteries.[accessed 2015 Mar 14].Available from:URL:http://medscape.com/article/900574-overview
8 Martins P,Castela E.Transposition of the great arteries.Orpha-net J Rare Dis 2008;3:27[PMID:18851735 DOI:10.1186/1-750-1172-3-27]
9 Rao PS.Diagnosis and management of cyanotic congenital heart disease:part I.Indian J Pediatr 2009;76:57-70[PMID:19391004DOI:10.1007/s12098-009-0030-4]
10 Canfield MA,Honein MA,Yuskiv N,Xing J,Mai CT,Collins JS,Devine O,Petrini J,Ramadhani TA,Hobbs CA,Kirby RS.National estimates and race/ethnic-specific variation of selected birth defects in the United States,1999-2001.Birth Defects Res A Clin Mol Teratol2006;76:747-756[PMID:17051527 DOI:10.1002/bdra.20294]
11 Samánek M,Slavík Z,ZborilováB,HrobonováV,VorískováM,Skovránek J.Prevalence,treatment,and outcome of heart disease in live-born children:a prospective analysis of 91,823 live-born children.Pediatr Cardiol 1989;10:205-211[PMID:2687820 DOI:10.1007/BF02083294]
12 Sampayo F,Pinto FF.The sex distribution of congenital cardiopathies.Acta Med Port 1994;7:413-418[PMID:7992642]
13 Samánek M.Boy:girl ratio in children born with different forms of cardiac malformation:a population-based study.Pediatr Cardiol1994;15:53-57[PMID:7997413 DOI:10.1007/BF00817606]
14 Bianca S,Ettore G.Sex ratio imbalance in transposition of the great arteries and possible agricultural environmental risk factors.Images Paediatr Cardiol 2001;3:10-14[PMID:22368601]
15 Gü?er S,Ince T,Kale G,Ak??ren Z,Ozkutlu S,Talim B,Ca?lar M.Noncardiac malformations in congenital heart disease:a retrospective analysis of 305 pediatric autopsies.Turk J Pediatr2005;47:159-166[PMID:16052857]
16 Abu-Sulaiman RM,Subaih B.Congenital heart disease in infants of diabetic mothers:echocardiographic study.Pediatr Cardiol 2004;25:137-140[PMID:14648003 DOI:10.1007/s00246-003-0538-8]
17 Becerra JE,Khoury MJ,Cordero JF,Erickson JD.Diabetes mellitus during pregnancy and the risks for specific birth defects:a population-based case-control study.Pediatrics 1990;85:1-9[PMID:2404255]
18 Loffredo CA,Silbergeld EK,Ferencz C,Zhang J.Association of transposition of the great arteries in infants with maternal exposures to herbicides and rodenticides.Am J Epidemiol 2001;153:529-536[PMID:11257060 DOI:10.1093/aje/153.6.529]
19 Okuda H,Nagao T.Cardiovascular malformations induced by prenatal exposure to phenobarbital in rats.Congenit Anom(Kyo-to)2006;46:97-104[PMID:16732768 DOI:10.1111/j.1741-4520.2006.00109.x]
20 Goldmuntz E,Bamford R,Karkera JD,dela Cruz J,Roessler E,Muenke M.CFC1 mutations in patients with transposition of the great arteries and double-outlet right ventricle.Am J Hum Genet2002;70:776-780[PMID:11799476 DOI:10.1086/339079]
21 Muncke N,Jung C,Rüdiger H,Ulmer H,Roeth R,Hubert A,Goldmuntz E,Driscoll D,Goodship J,Sch?n K,Rappold G.Missense mutations and gene interruption in PROSIT240,a novel TRAP240-like gene,in patients with congenital heart defect(transposition of the great arteries).Circulation 2003;108:2843-2850[PMID:14638541]
22 Animasahun A,Kehinde O,Falase O,Odusanya O,Njokanma F.Caregivers of Children with Congenital Heart Disease:Does Socioeconomic Class Have Any Effect on Their Perceptions?Congenit Heart Dis 2015;10:248-253[PMID:25196209 DOI:10.1111/chd.12210]
23 Jaiyesimi F,Antia AU.Congenital heart disease in Nigeria:a tenyear experience at UCH,Ibadan.Ann Trop Paediatr 1981;1:77-85[PMID:6185056]
24 Ashworth M,Al Adnani M,Sebire NJ.Neonatal death due to transposition in association with premature closure of the oval foramen.Cardiol Young 2006;16:586-589[PMID:17116273 DOI:10.1017/S1047951106000850]
25 Chiou HL,Moon-Grady A,Rodriguez R,Konia T,Parrish M,Milstein J.A rare lethal combination of premature closure of the foramen ovale and d-transposition of the great arteries with intact ventricular septum.Int J Cardiol 2008;130:e57-e59[PMID:18191244 DOI:10.1016/j.ijcard.2007.11.055]
26 Ferencz C,Brenner JI,Loffredo C,Kappetein AP,Wilson PD.Transposition of great arteries:etiologic distinctions of out-flow tract defects in a case-control study of risk factors.In:Clark EB,Markwald RR,Takao A,editors.Developmental mechanisms of heart disease.Armonk,NY:Futura Publishing,1995:639-653
27 Ferencz C,Loffredo CA,Correa-Villasenor A,Wilson PD.Genetic and environmental risk factors of major cardiovascular malformations;the Baltimore-Washington Infant Study,1981-1989.In:Ferencz C,Loffredo CA,Correa-Villasenor A,Wilson PD,editors.Perspective in Pediatric Cardiology.1st ed.Armonk,NY:Futura Publishing,1997:867-868
2 Botto LD,Correa A,Erickson JD.Racial and temporal variations in the prevalence of heart defects.Pediatrics 2001;107:E32[PMID:11230613 DOI:10.1542/PEDS.107.3.E32]
3 Fadero FF,Oyedeji OA,Aremu AA,Ogunkunle OO.Challenges in the management of congenital heart disease in contemporary Nigeria:An illustrative case of transposition of the great arteries.Nigerian J Pediat 2005;32:94-96
4 Adegboye VO,Omokhodion SI,Ogunkunle O,Brimmo AI,Adebo OA.Palliation for transposition of the great arteries.Nigerian JPediat 2003;5:129-133
5 Eze JC,Ezemba N.Open-heart surgery in Nigeria:indications and challenges.Tex Heart Inst J 2007;34:8-10[PMID:17420786]
6 Adebonojo SA.How viable are the cardiac programmes in West Africa today?In:Development of open heart surgery in West Africa;a historical perspective.Nigeria:Acecool Medical Publishers,2012:43-46
7 Charpie JR,Maher KO.Transposition of the great arteries.[accessed 2015 Mar 14].Available from:URL:http://medscape.com/article/900574-overview
8 Martins P,Castela E.Transposition of the great arteries.Orpha-net J Rare Dis 2008;3:27[PMID:18851735 DOI:10.1186/1-750-1172-3-27]
9 Rao PS.Diagnosis and management of cyanotic congenital heart disease:part I.Indian J Pediatr 2009;76:57-70[PMID:19391004DOI:10.1007/s12098-009-0030-4]
10 Canfield MA,Honein MA,Yuskiv N,Xing J,Mai CT,Collins JS,Devine O,Petrini J,Ramadhani TA,Hobbs CA,Kirby RS.National estimates and race/ethnic-specific variation of selected birth defects in the United States,1999-2001.Birth Defects Res A Clin Mol Teratol2006;76:747-756[PMID:17051527 DOI:10.1002/bdra.20294]
11 Samánek M,Slavík Z,ZborilováB,HrobonováV,VorískováM,Skovránek J.Prevalence,treatment,and outcome of heart disease in live-born children:a prospective analysis of 91,823 live-born children.Pediatr Cardiol 1989;10:205-211[PMID:2687820 DOI:10.1007/BF02083294]
12 Sampayo F,Pinto FF.The sex distribution of congenital cardiopathies.Acta Med Port 1994;7:413-418[PMID:7992642]
13 Samánek M.Boy:girl ratio in children born with different forms of cardiac malformation:a population-based study.Pediatr Cardiol1994;15:53-57[PMID:7997413 DOI:10.1007/BF00817606]
14 Bianca S,Ettore G.Sex ratio imbalance in transposition of the great arteries and possible agricultural environmental risk factors.Images Paediatr Cardiol 2001;3:10-14[PMID:22368601]
15 Gü?er S,Ince T,Kale G,Ak??ren Z,Ozkutlu S,Talim B,Ca?lar M.Noncardiac malformations in congenital heart disease:a retrospective analysis of 305 pediatric autopsies.Turk J Pediatr2005;47:159-166[PMID:16052857]
16 Abu-Sulaiman RM,Subaih B.Congenital heart disease in infants of diabetic mothers:echocardiographic study.Pediatr Cardiol 2004;25:137-140[PMID:14648003 DOI:10.1007/s00246-003-0538-8]
17 Becerra JE,Khoury MJ,Cordero JF,Erickson JD.Diabetes mellitus during pregnancy and the risks for specific birth defects:a population-based case-control study.Pediatrics 1990;85:1-9[PMID:2404255]
18 Loffredo CA,Silbergeld EK,Ferencz C,Zhang J.Association of transposition of the great arteries in infants with maternal exposures to herbicides and rodenticides.Am J Epidemiol 2001;153:529-536[PMID:11257060 DOI:10.1093/aje/153.6.529]
19 Okuda H,Nagao T.Cardiovascular malformations induced by prenatal exposure to phenobarbital in rats.Congenit Anom(Kyo-to)2006;46:97-104[PMID:16732768 DOI:10.1111/j.1741-4520.2006.00109.x]
20 Goldmuntz E,Bamford R,Karkera JD,dela Cruz J,Roessler E,Muenke M.CFC1 mutations in patients with transposition of the great arteries and double-outlet right ventricle.Am J Hum Genet2002;70:776-780[PMID:11799476 DOI:10.1086/339079]
21 Muncke N,Jung C,Rüdiger H,Ulmer H,Roeth R,Hubert A,Goldmuntz E,Driscoll D,Goodship J,Sch?n K,Rappold G.Missense mutations and gene interruption in PROSIT240,a novel TRAP240-like gene,in patients with congenital heart defect(transposition of the great arteries).Circulation 2003;108:2843-2850[PMID:14638541]
22 Animasahun A,Kehinde O,Falase O,Odusanya O,Njokanma F.Caregivers of Children with Congenital Heart Disease:Does Socioeconomic Class Have Any Effect on Their Perceptions?Congenit Heart Dis 2015;10:248-253[PMID:25196209 DOI:10.1111/chd.12210]
23 Jaiyesimi F,Antia AU.Congenital heart disease in Nigeria:a tenyear experience at UCH,Ibadan.Ann Trop Paediatr 1981;1:77-85[PMID:6185056]
24 Ashworth M,Al Adnani M,Sebire NJ.Neonatal death due to transposition in association with premature closure of the oval foramen.Cardiol Young 2006;16:586-589[PMID:17116273 DOI:10.1017/S1047951106000850]
25 Chiou HL,Moon-Grady A,Rodriguez R,Konia T,Parrish M,Milstein J.A rare lethal combination of premature closure of the foramen ovale and d-transposition of the great arteries with intact ventricular septum.Int J Cardiol 2008;130:e57-e59[PMID:18191244 DOI:10.1016/j.ijcard.2007.11.055]
26 Ferencz C,Brenner JI,Loffredo C,Kappetein AP,Wilson PD.Transposition of great arteries:etiologic distinctions of out-flow tract defects in a case-control study of risk factors.In:Clark EB,Markwald RR,Takao A,editors.Developmental mechanisms of heart disease.Armonk,NY:Futura Publishing,1995:639-653
27 Ferencz C,Loffredo CA,Correa-Villasenor A,Wilson PD.Genetic and environmental risk factors of major cardiovascular malformations;the Baltimore-Washington Infant Study,1981-1989.In:Ferencz C,Loffredo CA,Correa-Villasenor A,Wilson PD,editors.Perspective in Pediatric Cardiology.1st ed.Armonk,NY:Futura Publishing,1997:867-868