Assessing Risk Factors in Children with Congenital Heart Defects

A comprehensive multi-center study has shed light on key risk factors that influence survival outcomes in children with congenital heart defects, particularly those awaiting or recently undergoing heart transplantation. Published in the journal Circulation, the research analyzed data from 409 pediatric patients across 20 U.S. medical centers, focusing on their health status from listing for transplant through the first year post-transplant. The study found that 5.9% of children died while waiting for a heart transplant, and among those who received transplants, 8.5% did not survive the first year.

One significant finding was the impact of pre-existing conditions on mortality risk. Children with repeated hospitalizations in the year before transplant listing were twice as likely to die compared to those without such hospitalizations. Additionally, clinical cyanosis—characterized by dangerously low blood oxygen levels—was associated with a fivefold increase in death risk. Other factors linked to higher mortality included sleep apnea, mental health issues requiring treatment, and anatomical complications like obstruction of the Fontan pathway.

The study emphasizes improvements in survival rates among children with single-ventricle physiology who undergo the Fontan procedure. However, it highlights the importance of monitoring for low oxygen levels, which emerged as a stark predictor of poor outcomes. This insight is crucial for clinicians and families, indicating the need for early referral to advanced heart failure therapies when such risk factors are present.

These findings aim to enhance early identification of high-risk patients, prompting more aggressive management and timely transplant referral. Overall, the research offers a foundation for personalized care strategies that can improve transplant success and long-term health in children with complex congenital heart defects. Future research will focus on post-transplant quality of life and functional status, further shaping pediatric cardiac care.

Source: https://medicalxpress.com/news/2025-08-children-heart-defects.html