IS THERE AN INDICATION FOR SURGICAL-CORRE CTION OF AN AV-SEPTAL DEFECT IN PATIENTS WITH DOWN-SYNDROME

Background& Despite a low surgical mortality in patients with AV-septa l defect there is still controversy concerning the indication for surg ery of this lesion in patients with Down syndrome. Methods: Operative mortality and follow up in 26 patients with Down syndrome and surgical correction of complete AV-septal defect were analysed and compared wi th the course of 17 unoperated patients with Down syndrome and complet e AV-septal defect. Results: 3 of the operated patients died early pos toperatively. Only 1 of 22 survivors showed restriction of his physica l activity due to residual heart defect. 6 of the 17 patients without operation died, and 10 of the 11 survivors showed marked restriction o f their physical activity due to the heart lesion. Conclusion: We reco mmend early cardiological investigation and surgical correction of thi s operable malformation in patients with Down syndrome since their qua lity of life can be markedly improved.