[tri-med] Hopeful Publication/Cardiac Surgery/trisomy 18
- From: Barbara Farlow <b_farlow@xxxxxxxxxxx>
- To: undisclosed-recipients:;
- Date: Thu, 9 Apr 2009 00:41:19 +0000
Hello All,
This publication just came out from Japan which provides some hopeful
conclusions regarding the benefits of cardiac surgery for infants with Trisomy
18
http://www.springerlink.com/content/948188q3353x7347/
My concern is that these kinds of studies seldom differentiate between children
who have severe anomalies or other factors (weight, requirement for
resuscitation at birth, apnea, tone etc) that might suggest a poor outcome from
those who are more robust and for whom surgery might yield a more positive
outcome. Such an approach would likely yield improved statistics from which
decision making could be improved.
In the case of Trisomy 13, a significant factor would include the common, but
not always present brain anomaly, holoprosencephaly.
It appears that in Ontario. the average evidence-based statistic that relates
to all children with tri 13/18 independent of unique presentation appears to be
applied for the purpose of ranking for surgical consult in the wait list
strategy. Thus a diagnosis and consideration for surgery, based on a diagnosis
of the specific type or nature of the surgery required is precluded from
children who might benefit.
Barb
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