Cyanotic congenital heart diseases: A survey of 60 cases

Abstract

The medical records of all patients with congenital heart disease in department of pediatrics of Taleqani medical center during 7 years (1988-1994) were reviewed. 60 patients (30 males and 30 females) were found to have cyanotic congenital heart disease. The patients were 2 days to 15 years old (Median 36.5 months and SD 52.4 months). 58% of them were under one year of age. Low pulmonary blood flow was observed in 35 (58.3%) and high pulmonary blood flow in 25 (41.7%) in chest x-ray. Types of anomalies in order of frequency were as follows: Tetralogy of fallot 21 (35%), transposition of great arteries 16 (26.6%), tricuspid atresia 7 (11.7%), single ventricle 5 (8.3%), pulmonary atresia 4 (6.7%), total anomalous pulmonary venous return and ebstein's anomaly each 3 (5%), and hypoplastic left heart syndrome 1 (1.6%). 50% of patients with TGA had intact ventricular septum and the other half had VSD. Narrow base of cardiac silhouette was observed in 48% of patients. The common complications consisted of anemia 7 (11.7%), pneumonia 6 (10%), brain abscess and bacterial abscess of other organs each 5 (8.3%), cerebrovascular accident 4 (6.7%), and convulsion, sinusitis, gastroenteritis, septicemia each 2 (3.3%). 6 patients (010%) had extra-cardiac malformations. 7 patients underwent operation: 6 palliative and 1 corrective surgery. 11 (18.3%) died, vast majority of them (13.3%) suffered from TGA. In our study the order of frequency of the three first cyanotic lesions and the common complications of cyanotic cardiac disease were compatible with that in the literature. The high mortality rate in newborns with complex heart lesions is due to lack of surgical facilities in this age group