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1、Congenital heart malformation: Prevalence, severity, survival, and quality of life,先天性心脏病流行病学,The lowest values/1000 live births,Author Region Fyler 2.10 New England, USA Gardiner 2.17 Toronto, Canada Akman 3.20 Bogalusa, USA MacMahon 3.20 Birmingham, UK Mckeown 4.20 Birmingham, UK Bosi 4.60 Italy B
2、ierman 4.70 Hawaii,Prevalence of congenital heart malformation at birth,the highest values/ 1000 births,author Region Fischer 8.20 Tyrol,Austria Kerrebijn 8.26 Leiden , Netherland Grech 8.80 Malta Hoffmann 8.82 San Francisco, USA Meberg 9.02 Norway Nakazawa 10.00 Japan Manetti 12.30 Florence, Italy
3、Yerushalmi 11.70 California,USA,Prevalence of congenital heart malformation at birth,The oldest surveys/ 1000 live births,Author Date Prevalence () Macmahon 194049 3.23 Carlgren 1941 50 6.35 Harris 194450 5.90 Pleydell 194457 3.20 Landtman 1945 63 8.00 Richards 194653 5.50 Gardiner 194849 2.17 Musta
4、chi 194951 5.88,Prevalence of congenital heart malformation at birth,Recent data / 1000 live births,Author Date Prevalence() Grech 1990-94 8.80 Robida 1984-94 12.23 Bosi 1992-93 4.60 Anderson 1987-90 10.20 Cerboni 1988-90 6.08 Ferencz 1981-89 4.23 Pexieder 1986-87 6.04 Meberg 1982-88 9.02,Prevalence
5、 of congenital heart malformation at birth,Prevalence of congenital heart malformation at birth Regional differences/ 1000 live births,Region Mean Range difference place Europe 6.67 3.20 Birmingham, UK 12.30 Florence, Italy USA 5.76 3.20 Bogalusa 8.56 San Francisco Canada 3.97 2.17 Toronto 5.54 Albe
6、rta Other countries 8.97 6.08 Guadeloupe,Yearly fluctuation in Bohemian data from 1980 through 1989,Year No. of malformation Prevalence/ 1000 646 7.04 547 6.39 568 6.77 1983 548 6.73 566 6.97 495 6.16 436 5.53 455 5.82 402 5.11 367 4.80,Prevalence of congenital heart malformation at birth,The preval
7、ence was highest in October, and lowest in December ,June and July. The peak of the prevalence coincided with the epidemics of influenza in early pregnancy 8 and 9 months previously.,There was a definite seasonal variation,Ratio of boys to girls,Boys to girls with CHD: 51.9% to 48.1%,A higher propor
8、tion of boys was found with : DORV (2.68: 1); HLHS (2.25 :1) cTGA ( 2.11 :1);,A higher proportion of girls was found with:,PDA (1 :1.66); Ebsteins malformation (1 :1.57) Common arterial trunk (1:1.22),Distribution of congenital heart malformation,VSD 41.59% ASD 8.67% Aortic stenosis 7.77% Pulmonary
9、stenosis 5.81% cTGA 5.39% Aortic coarctation 5.29% PDA 5.07%,Greater than 5% of the overall number of malformation,Distribution of congenital heart malformation,AVSD 4.00% HLHS 3.42% TOF 3.36%,DORV, common arterial trunk and pulmonary atresia 1.05-1.37%,TAPVC 0.80% Tricuspid 0.78% Ebstein malformati
10、on 0.44% Interrupted aortic arch 0.44%,Spontaneous closure in 576 of 2092 recognized ventricular Septal defects, accounting for 27.5% of the cases,Critical heart malformation in neonates,10 most frequent Number proportion of total Malformations number seen(%),cTGA 102 84 Pul atresia 39 74 Coarctatio
11、n 34 49 HLHS 34 94 Tricuspid atresia 13 77 DORV 20 50 VSD 8 8 Common AT 8 50 TOF 7 28,Critical heart disease: which threaten life,which manifested by severve Congestive heart failure,deep cyanosis, or both symptoms,Death rate of children born with CHD,Survival in most frequent cardiac malformation,CHD Number survival (%) at age of 1 5 15yrs,VSD 2097 91 90 89 ASD 436 94 93 93 Aortic stenosis 391 90 89 88 PS 292 96 96 96 cTGA 271 62 56 5