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Congenital heart defects in patients with isolated microtia: evaluation using colour Doppler echocardiographic image

Published online by Cambridge University Press:  17 November 2020

Fengfeng Guo
Affiliation:
Department of Auricular Reconstruction, The Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS), Peking Union Medical College, Beijing, China
Lin Lin
Affiliation:
Department of Auricular Reconstruction, The Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS), Peking Union Medical College, Beijing, China
Xiaobo Yu
Affiliation:
Department of Auricular Reconstruction, The Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS), Peking Union Medical College, Beijing, China
YuPeng Song
Affiliation:
Department of Auricular Reconstruction, The Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS), Peking Union Medical College, Beijing, China
Qinghua Yang
Affiliation:
Department of Auricular Reconstruction, The Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS), Peking Union Medical College, Beijing, China
LeRen He
Affiliation:
Department of Auricular Reconstruction, The Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS), Peking Union Medical College, Beijing, China
Bo Pan
Affiliation:
Department of Auricular Reconstruction, The Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS), Peking Union Medical College, Beijing, China
Haiyue Jiang*
Affiliation:
Department of Auricular Reconstruction, The Plastic Surgery Hospital, Chinese Academy of Medical Sciences (CAMS), Peking Union Medical College, Beijing, China
*
Author for correspondence: Haiyue Jiang, PhD, Department of Auricular Reconstruction, Plastic Surgery Hospital, Badachu Road 33, Beijing 100144, China. Tel: +86 13911097829. E-mail: baihe090401@126.com

Abstract

Background:

The objective of this study was to delineate the characteristics and incidence of congenital heart disease (CHD) in patients with isolated microtia and to determine whether the prevalence of CHD among patients with isolated microtia increases with the severity of microtia.

Methods:

A total of 804 consecutive patients had a pre-operative colour Doppler echocardiographic examination. A retrospective study was performed with the clinical and imaging data from November, 2017 to January, 2019. The χ2 test was performed to analyse the interaction between isolated microtia and CHD.

Results:

With the colour Doppler echocardiographic examination’s data from 804 consecutive isolated microtia patients, we found CHD, including atrial septal defect, ventricular septal defect, tetralogy of Fallot, patent ductus arteriosus, and others, occurred in 52 of 804 patients (6.5%). Atrial septal defect prevalence in patients with isolated microtia was significantly higher than ventricular septal defect (24/804 versus 11/804, p < 0.05) and patent ductus arteriosus (24/804 versus 2/804, p < 0.001). Ventricular septal defect prevalence in patients with isolated microtia was significantly higher than patent ductus arteriosus (11/804 versus 2/804, p < 0.05). All four types of microtia (concha-type microtia, small concha-type microtia, lobule-type microtia, and anotia) had similar incidences of CHD with no difference in the incidences among these types (p > 0.05 respectively). Furthermore, there was no significant difference in the incidence of the atrial septal defect among the four subtypes (p > 0.05 respectively). Similarly, ventricular septal defect and patent ductus arteriosus also showed no differences (p > 0.05 respectively).

Conclusions:

The overall incidences of CHD and three most common CHD subtypes (atrial septal defect, ventricular septal defect, and patent ductus arteriosus) in patients with isolated microtia are higher than general population. The prevalence of CHD among patients with isolated microtia does not increase with the severity of microtia. According to our experience in this study, we suggest colour Doppler echocardiographic imaging should be performed for isolated microtia patients soon after birth if possible. Furthermore, for the plastic surgeon and anaesthesiologist, it is important to take pre-operative colour Doppler echocardiographic images which can help evaluate heart function to ensure the safety of the peri-operative period. Future studies when investigating CHDs associated with isolated microtia could focus on genetic and molecular mechanisms.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Hoffman, JI, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 18901900.10.1016/S0735-1097(02)01886-7CrossRefGoogle ScholarPubMed
Marelli, AJ, Mackie, AS, Ionescu-Ittu, R, Rahme, E, Pilote, L. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation 2007; 115: 163172.CrossRefGoogle ScholarPubMed
Yeh, SJ, Chen, HC, Lu, CW, et al. Prevalence, mortality, and the disease burden of pediatric congenital heart disease in Taiwan. Pediatr Neonatol 2013; 54: 113118.CrossRefGoogle ScholarPubMed
Egbe, A, Uppu, S, Stroustrup, A, Lee, S, Ho, D, Srivastava, S. Incidences and sociodemographics of specific congenital heart diseases in the United States of America: an evaluation of hospital discharge diagnoses. Pediatr Cardiol 2014; 35: 975982.CrossRefGoogle ScholarPubMed
Calzolari, E, Barisic, I, Loane, M, et al. Epidemiology of multiple congenital anomalies in Europe: a EUROCAT population-based registry study. Birth Defects Res A Clin Mol Teratol 2014; 100: 270276.CrossRefGoogle ScholarPubMed
Castilla, EE, Orioli, IM. Prevalence rates of microtia in South America. Int J Epidemiol 1986; 15: 364368.CrossRefGoogle ScholarPubMed
Harris, J, Källén, B, Robert, E. The epidemiology of anotia and microtia. J Med Genet 1996; 33: 809813.CrossRefGoogle ScholarPubMed
Kaye, CI, Rollnick, BR, Hauck, WW, et al. Microtia and associated anomalies: statistical analysis. Am J Med Genet 1989; 34: 574578.10.1002/ajmg.1320340424CrossRefGoogle ScholarPubMed
Mastroiacovo, P, Corchia, C, Botto, LD, et al. Epidemiology and genetics of microtia-anotia: a registry-based study on over one million births. J Med Genet 1995; 32: 453457.CrossRefGoogle Scholar
Nagata, S. A new method of total reconstruction of the auricle for microtia. Plast Reconstr Surg 1993; 92: 187201.CrossRefGoogle ScholarPubMed
Nagata, S. Modication of the stages in total reconstruction of the auricle: Part I. Grafting the three-dimensional costal cartilage framework for lobule-type microtia. Plast Reconstr Surg 1994; 93: 221230 .CrossRefGoogle Scholar
Nagata, S. Modication of the stages in total reconstruction of the auricle: part II. Grafting the three-dimensional costal cartilage framework for concha-type microtia. Plast Reconstr Surg 1994; 93: 231242 .CrossRefGoogle Scholar
Nagata, S. Modication of the stages in total reconstruction of the auricle: part III. Grafting the three-dimensional costal cartilage framework for small concha-type microtia. Plast Reconstr Surg 1994; 93: 243253 CrossRefGoogle Scholar
Deng, K, Dai, L, Yi, L, et al. Epidemiologic characteristics and time trend in the prevalence of anotia and microtia in China. Birth Defects Res A Clin Mol Teratol 2016; 106: 8894.CrossRefGoogle ScholarPubMed
Bernier, PL, Stefanescu, A, Samoukovic, G, et al. The challenge of congenital heart disease worldwide: epidemiologic and demographic facts. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2010; 13: 2634.CrossRefGoogle ScholarPubMed
Parker, SE, Mai, CT, Canfield, MA, et al. National birth defects prevention network. upatent ductus arteriosusted national birth prevalence estimates for selected birth defects in the United States, 2004–2006. Birth Defects Res A Clin Mol Teratol 2010; 88: 10081016.CrossRefGoogle Scholar
Lee, K, Khoshnood, B, Chen, L, et al. Infant mortality from congenital malformations in the United States, 1970–1997. Obstet Gynecol 2001; 98: 620627.Google ScholarPubMed
van der Linde, D, Konings, EE, Slager, MA, et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol 2011; 58: 22412247.CrossRefGoogle ScholarPubMed
Zhang, Y, Jiang, H, Yang, Q, et al. Microtia in a Chinese specialty clinic population: clinical heterogeneity and associated congenital anomalies. Plast Reconstr Surg 2018; 142: 892903.CrossRefGoogle Scholar
Ramprasad, VH, Shaffer, AD, Jabbour, N. Utilization of diagnostic testing for renal anomalies and congenital heart disease in patients with microtia. Otolaryngol Head Neck Surg 2020; 21: 554558.CrossRefGoogle Scholar
Bartel-Friedrich, S. Congenital auricular malformations: description of anomalies and syndromes. Facial Plast Surg 2015; 31: 567580.Google ScholarPubMed
Sadler, TW, Rasmussen, SA. Examining the evidence for vascular pathogenesis of selected birth defects. Am J Med Genet A 2010; 152: 24262436.CrossRefGoogle Scholar