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Effects of universal critical CHD screening of neonates at a mid-sized California congenital cardiac surgery centre
- Source :
- Cardiology in the Young. 32:236-243
- Publication Year :
- 2021
- Publisher :
- Cambridge University Press (CUP), 2021.
-
Abstract
- Introduction:CHD affects over 1 million children in the United States. Studies show decreased mortality from CHD with newborn cardiac screening. California began a screening programme on 1 July, 2013. We evaluated the effect of mandatory screening on surgical outcomes at Loma Linda University Children’s Hospital since 1 July, 2013.Methods:We evaluated all infants having congenital heart surgery at Loma Linda University Children’s Hospital between 1 July, 2013 and 31 December, 2018. Primary target diagnoses include hypoplastic left heart syndrome, pulmonary atresia with intact ventricular septum, tetralogy of Fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia, and truncus arteriosus. Secondary target diagnoses include aortic coarctation, double outlet right ventricle, Ebstein anomaly, interrupted aortic arch, and single ventricle. Patients were stratified by timing of diagnosis (pre-screen, screen positive, and screen negative). Primary end points were post-operative length of stay, operative mortality, absolute mortality, and actuarial survival.Results:The cohort included 274 infants. Of these, 79% were diagnosed prior to screening (46% prenatally). Only 38% of those screened were positive, with 13% of the cohort having a “missed diagnosis.”Conclusions:Primary targets were more likely to be diagnosed by screening (53%), while secondary targets were unlikely to be diagnosed by screening (10%) (p = 0.004). Outcomes such as length of stay, operative mortality, and actuarial survival were not different based on timing of diagnosis (p > 0.05). Despite late diagnosis, those not diagnosed until after screening did not have adverse outcomes.
- Subjects :
- Heart Defects, Congenital
Pediatrics
medicine.medical_specialty
Transposition of Great Vessels
030204 cardiovascular system & hematology
Hypoplastic left heart syndrome
03 medical and health sciences
Neonatal Screening
0302 clinical medicine
Double outlet right ventricle
030225 pediatrics
Humans
Medicine
Tricuspid atresia
Cardiac Surgical Procedures
Child
Tetralogy of Fallot
business.industry
Interrupted aortic arch
Infant, Newborn
Infant
General Medicine
medicine.disease
Cardiac surgery
Pulmonary Atresia
Great arteries
Pediatrics, Perinatology and Child Health
Cardiology and Cardiovascular Medicine
business
Pulmonary atresia
Subjects
Details
- ISSN :
- 14671107 and 10479511
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Cardiology in the Young
- Accession number :
- edsair.doi.dedup.....21c26155c22d4ab61f1c54269e981d8c
- Full Text :
- https://doi.org/10.1017/s1047951121001797