The following is a summary of “Contemporary Trends in Cardiac Surgical Care for Trisomy 13 and 18 Patients Admitted to Hospitals in the United States,” published in the February 2024 issue of Pediatrics by Greenberg et al.

This retrospective study aimed to evaluate the rates of cardiac surgery and the clinical and demographic factors influencing the choice between surgical and non-surgical management of congenital heart disease (CHD) in patients with trisomy 13 (T13) and trisomy 18 (T18) across the United States.

Utilizing data from the Pediatric Health Information System, the researchers comprehensively analyzed all hospital admissions involving children (<18 years of age) diagnosed with T13 and T18 from 2003 to 2022. Through ICD codes, the study group identified the presence of CHD, extracardiac comorbidities/malformations, and cardiac surgery performance.

A total of 7,113 patients were identified, with CHD detected in 62% (1,625/2,610) of T13 cases and 73% (3,288/4,503) of T18 cases. The most prevalent CHD morphologies included isolated atrial/ventricular septal defects and aortic hypoplasia/coarctation. Surgical intervention was undertaken in 12% of patients with T13 and CHD and 17% of those with T18 and CHD. However, fewer than half of all patients with cardiac diagnoses underwent surgery. Non-surgical patients were more likely to be born prematurely, while the number of extracardiac comorbidities was similar between surgical and non-surgical patients with T13 and greater in surgical patients with T18. Importantly, hospital mortality for both surgical cohorts was below 10%.

Patients with T13 or T18 and CHD undergo surgical palliation at a relatively low national prevalence, with operative mortality below 10%. This suggests an opportunity for potential quality improvement in delivering cardiac surgery for these vulnerable patient populations.

Source: sciencedirect.com/science/article/abs/pii/S0022347624000581