Heterotaxy syndrome

Defining contemporary disease trends

Terence W. Prendiville, Leslie L. Barton, William R. Thompson, Doran L. Fink, Kathryn Holmes

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

The purpose of this study was to define a population of visceral heterotaxy and to investigate the incidence of bacterial sepsis in the current era of universal pediatric pneumococcal immunization. Pediatric echocardiography and radiology databases, along with electronic medical records, were searched for patients followed-up since birth between 1999 and 2009 with either asplenia or polysplenia and cardiac anatomy consistent with heterotaxy syndrome. A total of 29 patients were identified. Seven patients (24%) had a total of 8 sepsis events, and 6 patients (86%) developed sepsis while taking appropriately prescribed antibiotic prophylaxis. Of the patients with sepsis, 5 had polysplenia and 2 had asplenia. Sixty-two percent of sepsis events were nosocomially acquired. No cases of pneumococcal sepsis occurred after the introduction of the conjugated pneumococcal vaccination to the pediatric vaccination schedule. Bacterial sepsis was associated with a 44% mortality rate. An unexpected finding in 3 patients with visceral heterotaxy, asplenia, and an interrupted inferior vena cava (IVC) as the only anomaly on echocardiography was associated intestinal malrotation. Children with visceral heterotaxy remain at significant risk of life-threatening bacterial infection. In addition, the finding of interrupted IVC on echocardiography should prompt screening for intestinal malrotation, even in the absence of additional structural heart disease.

Original languageEnglish (US)
Pages (from-to)1052-1058
Number of pages7
JournalPediatric Cardiology
Volume31
Issue number7
DOIs
StatePublished - Oct 2010
Externally publishedYes

Fingerprint

Heterotaxy Syndrome
Sepsis
Echocardiography
Inferior Vena Cava
Pediatrics
Vaccination
Antibiotic Prophylaxis
Electronic Health Records
Bacterial Infections
Radiology
Heart Diseases
Immunization
Anatomy
Appointments and Schedules
Parturition
Databases
Mortality
Incidence

Keywords

  • Asplenia
  • Inferior vena cava
  • Malrotation
  • Polysplenia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Prendiville, T. W., Barton, L. L., Thompson, W. R., Fink, D. L., & Holmes, K. (2010). Heterotaxy syndrome: Defining contemporary disease trends. Pediatric Cardiology, 31(7), 1052-1058. https://doi.org/10.1007/s00246-010-9764-z

Heterotaxy syndrome : Defining contemporary disease trends. / Prendiville, Terence W.; Barton, Leslie L.; Thompson, William R.; Fink, Doran L.; Holmes, Kathryn.

In: Pediatric Cardiology, Vol. 31, No. 7, 10.2010, p. 1052-1058.

Research output: Contribution to journalArticle

Prendiville, TW, Barton, LL, Thompson, WR, Fink, DL & Holmes, K 2010, 'Heterotaxy syndrome: Defining contemporary disease trends', Pediatric Cardiology, vol. 31, no. 7, pp. 1052-1058. https://doi.org/10.1007/s00246-010-9764-z
Prendiville, Terence W. ; Barton, Leslie L. ; Thompson, William R. ; Fink, Doran L. ; Holmes, Kathryn. / Heterotaxy syndrome : Defining contemporary disease trends. In: Pediatric Cardiology. 2010 ; Vol. 31, No. 7. pp. 1052-1058.
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