Objective : This echocardio-graphic study aims to assess the incidence of cardiac abnormalities and their relevance to surgery amongst patients with oro-facial clefts.
Materials and methods : A retrospective analysis of 2150 case records of cleft patients from 2005 to 2012 was done. Primary outcome assessment was to evaluate the cardiac status of the cleft patients via echocardiograms by a pediatric cardiologist. Parameters also studied were the sex of the patient, type of clefting, the side of clefting, associated anomalies, syndromes associated and the type of marriage.
Results : Unilateral left sided complete cleft lip and palate was the most commonly occurring anomaly, followed by cleft palate and cleft lip with ±alveolus. Clefts were more common in men than women. Cardiac findings were classified into significant and insignificant to surgery. Significant cardiac findings are Atrial septal defect, ventricular septal defect, patent ductus arteriosus, valvular heart diseases, tetralogy of fallot, mitral valve prolapse, mitral stenosis, pulmonary aneurysm and AV concordance. Insignificant cardiac findings were mitral regurgitation, tricuspid and aortic regurgitations. The incidence of significant cardiac anomalies were 11.95%, incidence of insignificant cardiac findings 5.90%. More than one cardiac anomaly was seen in 14.39% of patients and the incidence of syndromic patients with cardiac anomaly was 6.614%. Consanguineous marriages yielded significantly more cleft children (64%). Most common associated anomaly with cardiac anomaly was anomaly of the ear.
Conclusion : This article adds substantial evidence to current data, as it is the largest study of its kind. Taking the prevalence of congenital heart disease (CHD) in normal and cleft population into account, the incidence of CHD in cleft population is disproportionately high. Hence this study highlights the need for an echocardiogram for all cleft patients, as undiagnosed cardiac defects can be devastating during surgery.