Prevalence of scoliosis in patients with Fontan circulation

Kadhim, Muayad; Pizarro, Christian; Holmes, Larry; Rogers, Kenneth; Kallur, Antony; Mackenzie, William G.

doi:10.1136/archdischild-2012-302329

Cited by 11 publications

(12 citation statements)

References 22 publications

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“…The 10-year incidence of scoliosis for patients without a syndrome or developmental delay was 6% for boys and 10% for girls, significantly higher than the 2% to 3% prevalence of scoliosis in the general population [1][2][3]. The incidence of scoliosis in the current study was similar to some studies [9,10,17] but lower than others [4,7,8]. The wide variability between studies likely reflects the heterogeneity of the population, length of follow-up, differences in patient selection, and the multifactorial etiology of the disease.…”

Section: Commentsupporting

confidence: 83%

“…The relationship between CHD and scoliosis is well recognized [5,11]. However, the risk factors for Data from the available literature shows the incidence of scoliosis in patients with CHD varies widely, from 2% to 44% [4][5][6][7][8][9][10][11]17]. In a study from Spain, Ruiz-Iban and colleagues [7] found a 34% prevalence of scoliosis among 128 patients with CHD who had undergone a single sternotomy before age 8 years [7].…”

Section: Commentmentioning

confidence: 99%

“…(Ann Thorac Surg 2018;105:1835-41) Ó 2018 by The Society of Thoracic Surgeons I diopathic scoliosis affects 2% to 3% of the general population, with progression occurring mainly during episodes of rapid growth [1][2][3]. Previous reports have identified a higher incidence of scoliosis among patients with congenital heart disease (CHD) [4][5][6][7][8][9][10][11]. The mechanisms for this increase in risk are incompletely understood.…”

mentioning

confidence: 99%

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Risk Factors for Development and Progression of Scoliosis After Pediatric Cardiothoracic Operations

Mery

Guzmán-Pruneda

León

et al. 2018

The Annals of Thoracic Surgery

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Section: Commentsupporting

confidence: 83%

Section: Commentmentioning

confidence: 99%

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confidence: 99%

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Risk Factors for Development and Progression of Scoliosis After Pediatric Cardiothoracic Operations

Mery

Guzmán-Pruneda

León

et al. 2018

The Annals of Thoracic Surgery

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“…Therefore, children who have undergone heart surgery need a follow-up examination, conducted by specialists, for timely detection of the spine deformity. 5 In patients with idiopathic scoliosis who do not receive timely treatment, cardiopulmonary insufficiency may develop due to right ventricular overload. 6,7 This demonstrates the importance of timely orthopedic care for this category of patients.…”

Section: Introductionmentioning

confidence: 99%

Correction of Scoliosis in Children With Congenital Heart Defects

Kudryakov¹,

Shavyrin²,

Kolesov

et al. 2018

Coluna/Columna

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Objective: The purpose of this study was to evaluate the results of treatment in patients with deformities of the spine and congenital heart defects. Methods: Eighty-seven children aged 10 to 18 years old (27 males and 60 females) were treated surgically due to scoliosis. Results: The minimum angle of the curvature arc was 68°. The deformity parameters were evaluated on the basis of the spine x-ray. In patients with combined and rigid forms of scoliosis, correction was performed using dorsal segmental instrumentation. Where there was rigid deformity and it was not possible to perform a front release according to the somatic indications, a one-stage dorsal correction was performed in conditions of halo traction in combination with SPO or Ponte osteotomy. In patients with moderate impairment of blood circulation in the presence of rigid curvature of the main arch, two-stage surgery was performed, with ventral release at the apex of deformation, followed by halo traction. As a second stage, dorsal correction and stabilization of the spine was performed. In the operated patients, the mean correction with dorsal instrumentation was 64.2%. An average of 12 vertebrae were included in fusion. The degree of apical vertebral body derotation was found to be up to 30% of the initial rotation. With the use of hybrid and hook systems, the average degree of derotation was 18%. According to the physical examination within one year, the parameters of the function of external respiration and bronchial permeability increased significantly, from 10% to 30%, which indicates the functional nature of changes in cardiorespiratory disorders. Level of evidence IV, Case series.

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“…Spine deformities are more common in patients who have been operated of the cardiac disorder by sternotomy or combined sternotomy and thoracotomy 1 . Kadhim and cols found that 9,8 % of patients operated of single ventricle by Fontan surgery presented radiological evidence of scoliosis 1,1 years after surgery [1], being the female patients more affected than male patients, showing a ratio of F5: M3. Conversely, Reckles found the same scoliosis incidence in a similar group of patients [2].…”

Section: Introductionmentioning

confidence: 99%

Anaesthetic Management of an Adolescent for Scoliosis Surgery with a Bidirectional Glenn circulation

Dominguez

Burgos

2017

JACCOA

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The relationship between congenital heart disease and scoliosis is well known. Most of these patients present deformities that can be included in the group on spine deformities associated to a congenital heart disease, and, in another patients, the fact of perform a sternotomy in the first infancy to correct partially the heart defect, predisposes to develop the spine deformity. The improvement of the life expectancy in these patients can increase the probability of being operated of non-cardiac surgery. The patients with single ventricle circulation do not have right ventricle, so that, the pulmonary blood flow depends of the central venous pressure. The prone position used for scoliosis correction could worsen the venous return and the cardiac output. We present a 17 years of female patient case, diagnosed of a kippel Feil syndrome and a complex congenital heart disease (dextrocardia, dextroapex, complete atrioventricular septal defect, double outlet right ventricle, transposition of great arteries, pulmonary stenosis and double inferior vena cava system) partially corrected by Glenn surgery at 2 years. She present a toracolumbar scoliosis that causes severe pulmonary restriction and gets worse her functional class. The patient was operated in prone position by posterior approach and the correction using pedicular screws and bars was developed. Hemodynamic invasive monitoring like Transesophageal echocardiogram (TEE) and continuous arterial pressure monitoring were used; somatosensorial evoked potentials were used too. The patient was carried to the intensive care unit hemodinamically stable. As a severe postoperative complication at the second postoperative day she present superior cava vein thrombosis that was not extended to the pulmonary artery anastomosis and that not compromise the Glenn function. She was anticoagulated with unfractionated heparin being the vein successfully recanalized. 10 days after she was discharged to the hospitalization area.

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Prevalence of scoliosis in patients with Fontan circulation

Abstract: There was a high prevalence of scoliosis in patients with Fontan circulation. We recommend interdisciplinary monitoring of these patients to diagnose spinal curve deformities in a timely manner.

Cited by 11 publications

References 22 publications

Risk Factors for Development and Progression of Scoliosis After Pediatric Cardiothoracic Operations

Risk Factors for Development and Progression of Scoliosis After Pediatric Cardiothoracic Operations

Correction of Scoliosis in Children With Congenital Heart Defects

Anaesthetic Management of an Adolescent for Scoliosis Surgery with a Bidirectional Glenn circulation

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