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Revisiting Atrioventricular Septal Defects: Exploring Chromosomal Abnormalities, Cardiac and Extracardiac Anomalies in a Contemporary Prenatal Cohort

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Abstract

To estimate if there is an association between partial AVSD with chromosomal abnormalities, cardiac and extracardiac malformations, and to report the outcomes of prenatally diagnosed AVSD in a large, contemporary cohort. This is a retrospective cohort study of 190 prenatally diagnosed fetal AVSD between 2014 and 2023. Type of AVSD (complete vs partial), additional cardiac findings, extracardiac findings, presence of a heterotaxy, results of prenatal karyotype, and pregnancy outcomes were documented and analyzed. A total of 190 cases of fetal AVSD were analyzed. Complete AVSDs comprised 141 (74.2%) of the cohort, while partial AVSDs comprised 49 (25.7%). Karyotype was completed in 131 cases, and in 98 (74.8%) cases chromosomal abnormalities were identified, with trisomy 21 being the most common (53/131, 40.5%). Complete AVSDs were associated with trisomy 21 (45.5%, p = 0.04), Isolated cases of complete AVSDs (p = 0.03). Partial AVSDs were associated with trisomy 18 (53.1%, p < 0.001). In cases of partial AVSDs with aneuploidies, 7 (70%) had an ostium primum defect and 20 (90.9%) of AV canal type VSD. Isolated partial AVSD had no clear association with aneuploidies. There were additional cardiac anomalies in 96 (50.5%) and extracardiac anomalies in 134 (70.5%) of the cohort. There were no differences between partial and complete AVSD in rate of additional cardiac and extracardiac anomalies. AVSD was part of a heterotaxy in 47 (24.7%) of cases, and heterotaxy was associated with complete AVSD in the majority of cases (43/47, 91.4%, p = 0.003). Fetal partial AVSDs are associated with trisomy 18. Fetal complete AVSDs, even isolated, are associated with trisomy 21. There were no differences in association of other aneuploidies, additional cardiac findings, or extracardiac anomalies between prenatally diagnosed complete AVSDs and partial AVSDs.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to thank Ms. Elif Delen Deveci for being an invaluable part of the perinatology team; arranging patient relations and helping authors in data collection.

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Authors and Affiliations

  1. Zeynep Kamil Women and Children’s Diseases Training and Research Hospital, Perinatology, University of Health Sciences, Istanbul, Turkey

    Işıl Ayhan, Oya Demirci & Ali Şahap Odacılar

  2. Siyami Ersek Cardiology and Cardiovascular Surgery Training and Research Hospital, Pediatric Cardiology, University of Health Sciences, Istanbul, Turkey

    İlker Kemal Yücel

  3. Zeynep Kamil Women and Children’s Diseases Training and Research Hospital, Medical Genetics, University of Health Sciences, Istanbul, Turkey

    Ali Karaman

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  1. Işıl Ayhan
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  2. Oya Demirci
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  4. İlker Kemal Yücel
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Ayhan, I., Demirci, O., Odacılar, A.Ş. et al. Revisiting Atrioventricular Septal Defects: Exploring Chromosomal Abnormalities, Cardiac and Extracardiac Anomalies in a Contemporary Prenatal Cohort. Pediatr Cardiol 45, 1036–1047 (2024). https://doi.org/10.1007/s00246-024-03477-x

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