Down syndrome - Congenital heart disease
The management of Down syndrome patients with heart disease is a well-published ethical dilemma. Controversy exists about whether to operate or not, and what lesions should be operated on. There is, to our knowledge, no published data on Down syndrome patients with congenital heart disease in southern Africa. This ethical dilemma is even worse in our country with its limited resources and is exacerbated by the complexity of heart disease in these children. The aim of this study was to analyse our data on patients with Down syndrome and heart disease and to establish whether surgery is feasible or not. Data on 67 Down syndrome patients were analysed. The pre-operative mortality rate was 23.8%, while the postoperative mortality rate was 20%. No patient with uncomplicated tetralogy of Fallot who was operated on died. Although no statistical difference between the two groups could be demonstrated, the quality of life of those operated on improved dramatically. In conclusion, the same indications applicable to patients with heart disease without Down syndrome must be applied to Down syndrome patients with heart disease.