Pediatric Cardiology

, Volume 31, Issue 1, pp 66–73 | Cite as

Cardiac Operations for North American Children with Rheumatic Diseases: 1985–2005

  • Cory Stingl
  • James H. Moller
  • Bryce A. Binstadt
Original Article

Abstract

Certain pediatric rheumatic diseases are known to affect the heart, sometimes requiring surgical intervention. The Pediatric Cardiac Care Consortium database was used to characterize cardiac surgical intervention among children with rheumatic diseases from 1985 to 2005. From this large database, the records for patients younger than 21 years who underwent cardiac surgery for any rheumatic disorder were extracted. The data collected included the type of procedure performed, the age at the time of the procedure, and the year the procedure was performed. The 261 pediatric patients identified underwent 361 cardiac surgical procedures for complications of rheumatic heart disease (RHD; 160 patients), neonatal lupus (NLE; 53 patients), Kawasaki disease (KD; 28 patients), systemic lupus erythematosus (SLE; 13 patients), and juvenile rheumatoid arthritis (JRA; 7 patients). Multiple procedures were performed for 23% of the patients. The most common procedures included pacemaker implantations among infants with NLE, coronary artery bypass grafts for KD primarily in 5- to 15-year-olds, and cardiac valve operations among adolescents with RHD, SLE, and JRA. Six perioperative deaths occurred. The proportion of annual pediatric cardiac surgical volume attributable to rheumatic diseases did not change during the period studied. Despite advances in their medical care, children with rheumatic diseases continue to sustain measurable morbidity and mortality due to the cardiovascular manifestations of their disease.

Keywords

Arthritis Kawasaki Lupus Rheumatic Surgery 

Notes

Acknowledgments

The authors thank Virgil Larson for assistance with data retrieval and Dr. Richard Vehe for helpful review of the manuscript. Dr. Binstadt was supported by NIH grant K08 AR054317-01, an Arthritis Foundation Arthritis Investigator Award, and startup funds from the University of Minnesota Department of Pediatrics.

References

  1. 1.
    Al-Abbad AJ, Cabral DA, Sanatani S, Sandor GG, Seear M, Petty RE, Malleson PN (2001) Echocardiography and pulmonary function testing in childhood onset systemic lupus erythematosus. Lupus 10:32–37CrossRefPubMedGoogle Scholar
  2. 2.
    Balmer C, Fasnacht M, Rahn M, Molinari L, Bauersfeld U (2002) Long-term follow-up of children with congenital complete atrioventricular block and the impact of pacemaker therapy. Europace 4:345–349CrossRefPubMedGoogle Scholar
  3. 3.
    Bitar FF, Hayek P, Obeid M, Gharzeddine W, Mikati M, Dbaibo GS (2000) Rheumatic fever in children: a 15-year experience in a developing country. Pediatr Cardiol 21:119–122CrossRefPubMedGoogle Scholar
  4. 4.
    Boris JR, Hollister JR, Tyson RW, Wolfe RR (1998) Severe aortic regurgitation with mechanical prosthetic valve replacement in pauciarticular juvenile rheumatoid arthritis. J Rheumatol 25:1211–1214PubMedGoogle Scholar
  5. 5.
    Burns JC, Kushner HI, Bastian JF, Shike H, Shimizu C, Matsubara T, Turner CL (2000) Kawasaki disease: a brief history. Pediatrics 106:E27CrossRefPubMedGoogle Scholar
  6. 6.
    Buyon JP, Hiebert R, Copel J, Craft J, Friedman D, Katholi M, Lee LA, Provost TT, Reichlin M, Rider L, Rupel A, Saleeb S, Weston WL, Skovron ML (1998) Autoimmune-associated congenital heart block: demographics, mortality, morbidity and recurrence rates obtained from a national neonatal lupus registry. J Am Coll Cardiol 31:1658–1666CrossRefPubMedGoogle Scholar
  7. 7.
    Carapetis JR, McDonald M, Wilson NJ (2005) Acute rheumatic fever. Lancet 366:155–168CrossRefPubMedGoogle Scholar
  8. 8.
    Carapetis JR, Steer AC, Mulholland EK, Weber M (2005) The global burden of group A streptococcal diseases. Lancet Infect Dis 5:685–694CrossRefPubMedGoogle Scholar
  9. 9.
    Carceller A, Tapiero B, Rubin E, Miro J (2007) Acute rheumatic fever: 27-year experience from the Montreal’s pediatric tertiary care centers. An Pediatr Barc 67:5–10CrossRefPubMedGoogle Scholar
  10. 10.
    Cervera R, Font J, Pare C, Azqueta M, Perez-Villa F, Lopez-Soto A, Ingelmo M (1992) Cardiac disease in systemic lupus erythematosus: prospective study of 70 patients. Ann Rheum Dis 51:156–159CrossRefPubMedGoogle Scholar
  11. 11.
    Chauvaud SM, Kalangos A, Berrebi AJ, Gaer AR, Acar C, Carpentier AF (1995) Systemic lupus erythematosus valvulitis: mitral valve replacement with a homograft. Ann Thorac Surg 60:1803–1805CrossRefPubMedGoogle Scholar
  12. 12.
    Delgado EA, Petty RE, Malleson PN, Patterson MW, D’Orsogna L, LeBlanc J (1988) Aortic valve insufficiency and coronary artery narrowing in a child with polyarticular juvenile rheumatoid arthritis. J Rheumatol 15:144–147PubMedGoogle Scholar
  13. 13.
    Doria A, Iaccarino L, Sarzi-Puttini P, Atzeni F, Turriel M, Petri M (2005) Cardiac involvement in systemic lupus erythematosus. Lupus 14:683–686CrossRefPubMedGoogle Scholar
  14. 14.
    Eronen M, Siren MK, Ekblad H, Tikanoja T, Julkunen H, Paavilainen T (2000) Short- and long-term outcome of children with congenital complete heart block diagnosed in utero or as a newborn. Pediatrics 106:86–91CrossRefPubMedGoogle Scholar
  15. 15.
    Gerber MA, Baltimore RS, Eaton CB, Gewitz M, Rowley AH, Shulman ST, Taubert KA (2009) Prevention of rheumatic fever and diagnosis and treatment of acute streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation 119:1541–1551CrossRefPubMedGoogle Scholar
  16. 16.
    Goldenberg J, Ferraz MB, Pessoa AP, Fonseca AS, Carvalho AC, Hilario MO, Atra E (1992) Symptomatic cardiac involvement in juvenile rheumatoid arthritis. Int J Cardiol 34:57–62CrossRefPubMedGoogle Scholar
  17. 17.
    Gotteiner N, Mavroudis C, Backer CL, Pahl E, Duffy CE, Dalzell V, Shulman ST (2002) Coronary artery bypass grafting for Kawasaki disease. Pediatr Cardiol 23:62–67CrossRefPubMedGoogle Scholar
  18. 18.
    Gunal N, Kara N, Akkok N, Cakar N, Kahramanyol O, Akalin N (2003) Cardiac abnormalities in children with systemic lupus erythematosus. Turk J Pediatr 45:301–305PubMedGoogle Scholar
  19. 19.
    Hillman ND, Tani LY, Veasy LG, Lambert LL, Di Russo GB, Doty DB, McGough EC, Hawkins JA (2004) Current status of surgery for rheumatic carditis in children. Ann Thorac Surg 78:1403–1408CrossRefPubMedGoogle Scholar
  20. 20.
    Hiraki LT, Benseler SM, Tyrrell PN, Hebert D, Harvey E, Silverman ED (2008) Clinical and laboratory characteristics and long-term outcome of pediatric systemic lupus erythematosus: a longitudinal study. J Pediatr 152:550–556PubMedGoogle Scholar
  21. 21.
    Holman RC, Curns AT, Belay ED, Steiner CA, Schonberger LB (2003) Kawasaki syndrome hospitalizations in the United States, 1997 and 2000. Pediatrics 112:495–501CrossRefPubMedGoogle Scholar
  22. 22.
    Izmirly PM, Rivera TL, Buyon JP (2007) Neonatal lupus syndromes. Rheum Dis Clin North Am 33:267–285 viCrossRefPubMedGoogle Scholar
  23. 23.
    Jaeggi ET, Hamilton RM, Silverman ED, Zamora SA, Hornberger LK (2002) Outcome of children with fetal, neonatal, or childhood diagnosis of isolated congenital atrioventricular block: a single institution’s experience of 30 years. J Am Coll Cardiol 39:130–137CrossRefPubMedGoogle Scholar
  24. 24.
    Kitamura S, Kameda Y, Seki T, Kawachi K, Endo M, Takeuchi Y, Kawasaki T, Kawashima Y (1994) Long-term outcome of myocardial revascularization in patients with Kawasaki coronary artery disease: a multicenter cooperative study. J Thorac Cardiovasc Surg 107:663–673; discussion 673–664PubMedGoogle Scholar
  25. 25.
    Kitamura S, Tsuda E, Wakisaka Y (2008) Pediatric coronary artery bypass grafting for Kawasaki disease: 20-years’ outcome. Nippon Rinsho 66:380–386PubMedGoogle Scholar
  26. 26.
    Lin CH, Lee ML, Hsu RB (2005) Cardiac surgery in patients with systemic lupus erythematosus. Interact Cardiovasc Thorac Surg 4:618–621CrossRefPubMedGoogle Scholar
  27. 27.
    Marijon E, Ou P, Celermajer DS, Ferreira B, Mocumbi AO, Jani D, Paquet C, Jacob S, Sidi D, Jouven X (2007) Prevalence of rheumatic heart disease detected by echocardiographic screening. N Engl J Med 357:470–476CrossRefPubMedGoogle Scholar
  28. 28.
    Miyake CY, Gauvreau K, Tani LY, Sundel RP, Newburger JW (2007) Characteristics of children discharged from hospitals in the United States in 2000 with the diagnosis of acute rheumatic fever. Pediatrics 120:503–508CrossRefPubMedGoogle Scholar
  29. 29.
    Moller JH, Borbas C (1990) The Pediatric Cardiac Care Consortium: a physician-managed clinical review program. QRB Qual Rev Bull 16:310–316PubMedGoogle Scholar
  30. 30.
    Moller JH, Powell CB, Joransen JA, Borbas C (1994) The pediatric cardiac care consortium—revisited. Jt Comm J Qual Improv 20:661–668PubMedGoogle Scholar
  31. 31.
    Omdal R, Lunde P, Rasmussen K, Mellgren SI, Husby G (2001) Transesophageal and transthoracic echocardiography and Doppler examinations in systemic lupus erythematosus. Scand J Rheumatol 30:275–281CrossRefPubMedGoogle Scholar
  32. 32.
    Oshiro AC, Derbes SJ, Stopa AR, Gedalia A (1997) Anti-Ro/SS-A and anti-La/SS-B antibodies associated with cardiac involvement in childhood systemic lupus erythematosus. Ann Rheum Dis 56:272–274CrossRefPubMedGoogle Scholar
  33. 33.
    Roldan CA, Shively BK, Crawford MH (1996) An echocardiographic study of valvular heart disease associated with systemic lupus erythematosus. N Engl J Med 335:1424–1430CrossRefPubMedGoogle Scholar
  34. 34.
    Tsuda E, Kitamura S (2004) National survey of coronary artery bypass grafting for coronary stenosis caused by Kawasaki disease in Japan. Circulation 110:II61–II66CrossRefPubMedGoogle Scholar
  35. 35.
    Yanagawa H, Nakamura Y, Yashiro M, Ojima T, Tanihara S, Oki I, Zhang T (1998) Results of the nationwide epidemiologic survey of Kawasaki disease in 1995 and 1996 in Japan. Pediatrics 102:E65CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Cory Stingl
    • 1
  • James H. Moller
    • 2
    • 3
  • Bryce A. Binstadt
    • 1
  1. 1.Division of Pediatric Rheumatology, Department of PediatricsUniversity of Minnesota Amplatz Children’s HospitalMinneapolisUSA
  2. 2.Division of Pediatric Cardiology, Department of PediatricsUniversity of Minnesota Amplatz Children’s HospitalMinneapolisUSA
  3. 3.Pediatric Cardiac Care ConsortiumUniversity of MinnesotaMinneapolisUSA

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