Hostname: page-component-848d4c4894-wzw2p Total loading time: 0 Render date: 2024-06-08T10:56:37.164Z Has data issue: false hasContentIssue false
  • English
  • Français

Cardiac Surgical Repair Should Be Offered to Infants with Trisomy 18, Interrupted Aortic Arch and Ventricular Septal Defect

Published online by Cambridge University Press:  01 January 2021

Minoo N. Kavarana
Get access Rights & Permissions [Opens in a new window]

Abstract

The management of children born with trisomy 18 is controversial, and both providers and parents often have differing opinions. Many parents choose to terminate the pregnancy while others go forward, making decisions based on their beliefs, understanding, and physician recommendations. Physicians are similarly divided regarding treatment of these children, as some feel that aggressive treatments are futile while others defer to the parents' wishes.

Interrupted aortic arch with ventricular septal defect in children with trisomy 18 presents an ethical dilemma that highlights the kinds of controversies in medical decision making facing physicians on a daily basis. Repair of interrupted aortic arch with ventricular septal defect poses a high risk to newborns with or without trisomy 18. Therefore, the option for surgery should be treated as with any routine informed consent process. Parents should be counseled about the risks, benefits, alternatives, and the likelihood of success both short and long term and be should offered a choice between surgery and palliative care.

Type
Symposium Articles
Information
Journal of Law, Medicine & Ethics , Volume 44 , Issue 2: Ethical and Legal Issues in Pediatrics , Summer 2016 , pp. 283 - 285
Copyright
Copyright © American Society of Law, Medicine and Ethics 2016

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

McCrindle, B. W., Tchervenkov, C. I., and Konstantinov, I. E., et al. “Risk Factors Associated with Mortality and Interventions in 472 Neonates with Interrupted Aortic Arch: A Congenital Heart Surgeons Society Study,” Journal of Thoracic and Cardiovascular Surgery 129 (2005): 343–350.CrossRefGoogle Scholar
Wang, M. C. and Fu, Y. C., “Hybrid Therapy for Interrupted Aortic Arch with Aortopulmonary Window in a Low Birth Weight Infant,” Catheterization and Cardiovascular Interventions 78, no. 6 (2011): 945-947.Google Scholar
Root, S. and Carey, J. C., “Survival in Trisomy 18,” American Journal of Medical Genetics Part A 49 (1994): 170-174.CrossRefGoogle Scholar
Rasmussen, S. A., Wong, L., Yang, Q., May, K., and Friedman, J. M., “Population-Based Analyses of Mortality in Trisomy 13 and Trisomy 18,” Pediatrics 111 (2003): 777-784.CrossRefGoogle Scholar
Graham, E. M., Bradley, S. M., Shirali, G. S., Hills, C. B., and Atz, A. M., “Pediatric Cardiac Care Consortium: Effectiveness of Cardiac Surgery in Trisomies 13 and 18 (from the Pediatric Cardiac Care Consortium),” American Journal of Cardiology 93, no. 6 (2004): 801-803; Muneuchi, J., Yamamoto, J., Takahashi, Y., Watanabe, M., Yuge, T., Ohno, T., Imoto, Y., Sese, A., and Joo, K., “Outcomes of Cardiac Surgery in Trisomy 18 Patients,” Cardiology in the Young 21, no. 2 (2011): 209-215.CrossRefGoogle Scholar
Graham et al., supra note 5.Google Scholar
Id.Google Scholar
Muneuchi et al., supra note 5.Google Scholar
Yamagishi, H., “Cardiovascular Surgery for Congenital Heart Disease Associated with Trisomy 18,” General Thoracic and Cardiovascular Surgery 58 (2010): 217-219.Google Scholar
Id.Google Scholar
Jonas, R. A., Quaegebeur, J. M., Kirklin, J. W., Blackstone, E. H., and Daicoff, G., “Outcomes in Patients with Interrupted Aortic Arch and Ventricular Septal Defect,” Journal of Thoracic and Cardiovascular Surgery 107 (1994): 1099-1109, at 1109.CrossRefGoogle Scholar