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Unequal Cardiac Care for Children With Down's Syndrome
Henry M. Sondheimer, MD;
Craig J. Byrum, MD;
Marie S. Blackman, MD
Am J Dis Child. 1985;139(1):68-70.
Abstract
• We reviewed the course of all 36 new patients with complete atrioventricular canal defect (CAVC) seen in a regional center from 1977 through 1982. Of this group of 36 patients, 28 had Down's syndrome. The eight children without Down's syndrome were all referred before 1 year of age. Surgical intervention was possible for each child. Of the 28 with Down's syndrome, 18 were referred before 1 year of age. Surgery intervention was possible in 17(94%) of 18. Of the ten children with Down's syndrome referred after 1 year of age, surgical therapy was not possible in five because of pulmonary vascular obstructive disease (PVOD). Since CAVC is known to progress to PVOD at an early age, it is not surprising that half of those patients referred after 1 year of age had become inoperable because of this complication. We therefore concluded that in spite of the severity of CAVC some children with Down's syndrome and this heart condition are being denied standard cardiac care by the process of late referral.
(AJDC 1985;139:68-70)
Author Affiliations
From the Division of Cardiology, Department of Pediatrics, State University of New York—Upstate Medical Center, Syracuse.
Footnotes
Read in part before the annual meeting of the American Pediatric Society—Society for Pediatric Research, Washington, DC, May 5, 1983.
Reprint requests to Division of Pediatric Cardiology, SUNY-Upstate Medical Center, 750 E Adams St, Syracuse, NY 13210 (Dr Sondheimer).
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