Tetralogia de Fallot em crianças e adolescentes do Nordeste brasileiro: um estudo descritivo

Lucinéia Santos da Silva; Ridalva Dias Martins; Márcia Maria Carneiro Oliveira; Marimeire Morais da Conceição; Rosinete Souza Barata; Edsângela Thalita Passos Barreto; Camila Martins

Lucinéia Santos da Silva Universidade Federal da Bahia (Salvador, Bahia, Brasil) https://orcid.org/0000-0001-5642-0395
Ridalva Dias Martins Universidade Federal da Bahia (Salvador, Bahia, Brasil) https://orcid.org/0000-0003-0295-9998
Márcia Maria Carneiro Oliveira Universidade Federal da Bahia (Salvador, Bahia, Brasil) https://orcid.org/0000-0003-2294-0872
Marimeire Morais da Conceição Universidade Federal da Bahia (Salvador, Bahia, Brasil) https://orcid.org/0000-0002-9568-6468
Rosinete Souza Barata Universidade Federal da Bahia (Salvador, Bahia, Brasil) https://orcid.org/0000-0002-9084-1625
Edsângela Thalita Passos Barreto Universidade Federal da Bahia (Salvador, Bahia, Brasil) https://orcid.org/0000-0001-9048-8182
Camila Martins Universidade Federal da Bahia (Salvador, Bahia, Brasil) https://orcid.org/0000-0001-5009-2503

Palabras clave: Niño, Adolescente, Tetralogía de Fallot, Enfermería, Enfermedad Crónica

Key-words: Child, Adolescent, Tetralogy of Fallot, Nursing, Chronic Disease

Palavras chave: Criança, Adolescente, Tetralogia de Fallot, Enfermagem, Doença Crônica

Resumen

Objetivo: caracterizar el perfil demográfico y clínico de niños y adolescentes con tetralogía de Fallot y sus complicaciones clínicas.
Materiales y método: estudio exploratorio, descriptivo, cuantitativo, transversal, basado en la iniciativa Fortalecimiento del Reporte de Estudios Observacionales en Epidemiología (STROBE), que incorpora el análisis de las historias clínicas electrónicas de niños y adolescentes en seguimiento por consulta externa en cardiología y cirugía cardiovascular pediátrica en el nordeste de Brasil. Se recolectaron datos de 2017 a 2019, analizando variables demográficas, clínicas y complicaciones. Además, se realizó el cálculo de la mediana, el rango intercuartílico y las frecuencias absolutas y relativas.
Resultados: de los 670 niños y adolescentes tratados con cardiopatía congénita, 104 (15,5%) fueron diagnosticados con tetralogía de Fallot, la mayoría eran de sexo masculino (59,6%) entre 10 y 19 años (49%). Se evidenciaron complicaciones como ictus isquémico (6,7%), endocarditis (2,9%) e insuficiencia cardíaca (1,9%).
Conclusiones: es necesario que los servicios y los profesionales de la salud, especialmente en enfermería, estén preparados para identificar los signos y síntomas de la tetralogía de Fallot y así reconocer posibles complicaciones relacionadas con esta cardiopatía congénita, con el fin de promover una atención de la salud con calidad

Abstract

Objective: To characterize the demographic and clinical profile of children and adolescents with tetralogy of Fallot and their clinical complications.
Materials and method: Exploratory, descriptive, quantitative, cross-sectional study, based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative. This study involved the analysis of electronic medical records of children and adolescents under follow-up at a reference outpatient clinic in cardiology and pediatric cardiovascular surgery in northeastern Brazil. Data were collected from 2017 to 2019. Demographic and clinical variables and complications were evaluated, and the median, interquartile range, absolute and relative frequencies were calculated.
Results: Out of 670 children and adolescents treated with congenital heart disease, 104 (15.5%) were diagnosed with tetralogy of Fallot. Most of these were male (59.6%) aged between 10 and 19 (49%). Among the complications identified we can mention ischemic stroke (6.7%), endocarditis (2.9%), and heart failure (1.9%).
Conclusions: It is necessary that health services and professionals, especially nurses, are prepared to identify the signs and symptoms of tetralogy of Fallot and recognize the possible complications related to this congenital heart disease in order to promote quality health care

Resumo

Objetivo: caracterizar o perfil demográfico e clínico de crianças e adolescentes com tetralogia de Fallot e suas complicações clínicas.
Materiais e método: estudo exploratório, de caráter descritivo, quantitativo, de corte transversal, com base na iniciativa Strengthening the Reporting of Observational Studies in Epidemiology (Strobe), a partir da análise dos prontuários eletrônicos de crianças e adolescentes acompanhadas em um ambulatório de referência em cardiologia e cirurgia cardiovascular pediátrica no Nordeste do Brasil. Os dados foram coletados de 2017 a 2019. Foram avaliadas variáveis demográficas, clínicas e complicações ocorridas, e calculadas a mediana, intervalo interquartil, frequências absolutas e relativas.
Resultados: das 670 crianças e adolescentes atendidos com cardiopatia congênita, 104 (15,5%) apresentam diagnóstico de tetralogia de Fallot; a maioria era do sexo masculino (59,6%) e com idade entre 10 e 19 anos (49%). Foram evidenciadas complicações como acidente vascular cerebral isquêmico (6,7%), endocardite (2,9%) e insuficiência cardíaca (1,9%).
Conclusões: faz-se necessário que os serviços e os profissionais de saúde, em especial o enfermeiro, estejam preparados para identificar os sinais e sintomas da tetralogia de Fallot e reconheçam as possíveis complicações relacionadas a essa cardiopatia congênita a fim de promover um cuidado de saúde com qualidade

Bibliography

(1) van Nisselrooij AEL; Teunissen AKK; Clur SA; Rozendaal L; Pajkrt E; Linskens IH et al. Why are congenital heart defects being missed? Ultrasound Obstet Gynecol. 2020;55(6):747-757. https://doi.org/10.1002/uog.20358
(2) Villafañe J; Feinstein JA; Jenkins KJ; Vincent RN; Walsh EP; Dubin AM et al. Hot topics in tetralogy of Fallot. J Am Coll Cardiol. 2013;62(23):2155-2166. https://doi.org/10.1016/j.jacc.2013.07.100
(3) Jacobs JP; Mayer JE Jr; Mavroudis C; O’Brien SM; Austin EH; Pasquali SK et al. The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2017 Update on Outcomes and Quality. Ann Thorac Surg. 2017;103(3):699-709. https://doi.org/10.1016/j.athoracsur.2017.01.004
(4) Brasil. Ministério da Saúde. Portaria n.º 1.727, de 11 de julho de 2017. Aprova o Plano Nacional de Assistência à Criança com Cardiopatia Congênita. 2017. https://bit.ly/3ASiIm4
(5) Leonardi B; Secinaro A; Calvieri C; Perrone MA; Gimigliano F; Muscogiuri G et al. The role of 3D imaging in the follow-up of patients with repaired tetralogy of Fallot. Eur Rev Med Pharmacol Sci. 2019;23(4):1698-1709. https://doi.org/10.26355/eurrev_201902_17132
(6) Martins IF; Doles IC; Bravo-Valenzuela NJM; Santos AOR; Varella MSP. When is the best time for corrective surgery in patients with tetralogy of fallot between 0 and 12 months of age? Braz. J. Cardiovasc. Surg. 2018;33(5):505-510. https://doi.org/10.21470/1678-9741-2018-0019
(7) Silva LDC; Pavão TCA; Souza JCB; Frias LMP. Diagnóstico precoce das cardiopatias congênitas: uma revisão integrativa. J Manag Prim Health Care. 2018;9:e10. https://doi.org/10.14295/jmphc.v9i0.336
(8) França JCQ; Bestetti RB; Cardinalli Neto A; Murad Junior JA; Longo GS; Sinhorini ERA. Long survival in patient with unrepaired Tetralogy of Fallot and Down Syndrome. Arq Bras Cardiol: Imagem cardiovasc. 2016;29(3):99-102. https://doi.org/10.5935/2318-8219.20160025
(9) Loomba RS; Buelow MW; Woods RK. Complete repair of tetralogy of Fallot in the neonatal versus non-neonatal period: A meta-analysis. Pediatr Cardiol. 2017;38:893-901. https://doi.org/10.1007/s00246-017-1579-8
(10) Ghimire LV; Chou FS; Devoe C; Moon-Grady A. Comparison of in-hospital outcomes when repair of tetralogy of Fallot is in the neonatal period versus in the post-neonatal period. Am J Cardiol. 2020;125(1):140-145. https://doi.org/10.1016/j.amjcard.2019.09.025
(11) Ven JPG; Bosch E; Bogers AJCC; Helbing WA. Current outcomes and treatment of tetralogy of Fallot. F1000Research. 2019;8:1530. https://doi.org/10.12688/f1000research.17174.1
(12) Rahmath MRK; Boudjemline Y. Tetralogy of Fallot will be treated interventionally within two decades. Pediatr Cardiol. 2020;41:539-545. https://doi.org/10.1007/s00246-020-02297-z
(13) Bhat M; Mercer-Rosa L; Fogel MA; Harris MA; Paridon SM; McBride MG et al. Longitudinal changes in adolescents with TOF: Implications for care. Eur Heart J Cardiovasc Imaging. 2017;18(3):356-363. https://doi.org/10.1093/ehjci/jew272
(14) Manshaei R; Merico D; Reuter MS; Engchuan W; Mojarad BA; Chaturvedi R et al. Genes and pathways implicated in tetralogy of Fallot revealed by ultra-rare variant burden analysis in 231 genome sequences. Front Genet. 2020;11:957. https://doi.org/10.3389/fgene.2020.00957
(15) Bhatt SM; Goldmuntz E; Cassedy A; Marino BS; Mercer-Rosa L. Quality of life is diminished in patients with tetralogy of Fallot with mild residual disease: A comparison of tetralogy of Fallot and isolated valvar pulmonary stenosis. Pediatr Cardiol. 2017;38:1645-1653. https://doi.org/10.1007/s00246-017-1709-3
(16) O'Byrne ML; DeCost G; Katcoff H; Savla JJ; Chang J; Goldmuntz E et al. Resource utilization in the first 2 years following operative correction for tetralogy of Fallot: Study using data from the optum’s de-identified clinformatics data mart insurance claims database. J Am Heart Assoc. 2020;9(15):e016581. https://doi.org/10.1161/JAHA.120.016581
(17) Brasil. Ministério da Saúde. Resolução n.º 466, de 12 de dezembro de 2012. 2012. https://conselho.saude.gov.br/resolucoes/2012/Reso466.pdf
(18) Ekure EN; Kalu N; Sokunbi OJ; Kruszka P; Olusegun-Joseph AD; Ikebudu D et al. Clinical epidemiology of congenital heart disease in Nigerian children, 2012-2017. Birth Defects Res. 2018;110(16):1233-1240. https://doi.org/10.1002/bdr2.1361
(19) Abqari S; Gupta A; Shahab T; Rabbani MU; Ali SM; Firdaus U. Profile and risk factors for congenital heart defects: A study in a tertiary care hospital. Ann Pediatr Cardiol. 2016;9(3):216-221. http://doi.org/10.4103/0974-2069.189119
(20) Pérez-Lescure PJ; Mosquera GM; Latasa ZP; Crespo MD. Incidencia y evolución de las cardiopatías congénitas en España durante 10 años (2003-2012). An Pediatr. 2018;89(5):294-301. https://doi.org/10.1016/j.anpedi.2017.12.009
(21) Animasahun BA; Madise-Wobo AD; Kusimo OY. Cyanotic congenital heart diseases among Nigerian children. Cardiovasc Diagn Ther. 2017;7(4):389-396. http://doi.org/10.21037/cdt.2017.06.03
(22) Xie D; Fang J; Liu Z; Wang H; Yang T; Sun Z et al. Epidemiology and major subtypes of congenital heart defects in Hunan Province, China. Medicine. 2018;97(31):e11770. https://doi.org/10.1097/MD.0000000000011770
(23) Egbe A; Uppu S; Stroustrup A; Lee S; Ho D; Srivastava S. Incidences and sociodemographics of specific congenital heart diseases in the United States of America: an evaluation of hospital discharge diagnoses. Pediatr Cardiol. 2014;35:975-982. https://doi.org/10.1007/s00246-014-0884-8
(24) Vázquez-López M; Castro-de Castro P; Barredo-Valderrama E; Miranda-Herrero MC; Gil-Villanueva N; Alcaraz-Romero AJ et al. Ictus isquémico en niños con cardiopatía: estudio epidemiológico. Neurología. 2017;32(9):602-609. https://doi.org/10.1016/j.nrl.2016.03.015
(25) Costa BO; Marras APB; Furlan MFFM. Evolução clínica de pacientes após correção total de tetralogia de Fallot em Unidade de Terapia Intensiva Cardiológica Pediátrica. Arq Ciênc Saúde. 2016;23(1):42-46. https://bit.ly/42pIqbY
(26) He F; Feng Z; Chen Q; Jiao Y; Hua Z; Zhang H et al. Whether pulmonary valve replacement in asymptomatic patients with moderate or severe regurgitation after tetralogy of Fallot repair is appropriate: A case-control study. JAHA. 2019;8(1):e010689. https://doi.org/10.1161/JAHA.118.010689
(27) Mizukawa M; Moriyama M; Yamamoto H; Rahman MM; Naka M; Kitagawa T et al. Nurse-Led collaborative management using telemonitoring improves quality of life and prevention of rehospitalization in patients with heart failure. Int Heart J. 2019; 60(6):1293-1302. https://doi.org/10.1536/ihj.19-313
(28) Mouws EMJP; de Groot NMS; Woestijne PC; Jong PL; Helbing WA; Beynum IM et al. Tetralogy of Fallot in the current era. Semin Thorac Cardiovasc Surg. 2019;31(3):496-504. https://doi.org/10.1053/j.semtcvs.2018.10.015
(29) Smith CA; McCracken C; Thomas AS; Spector LG; St Louis JD; Oster ME et al. Long-term outcomes of tetralogy of Fallot: A study from the pediatric cardiac care consortium. JAMA Cardiol.2019;4(1):34-41. https://doi.org/10.1001/jamacardio.2018.4255
(30) Egbe AC; Kothapalli S; Borlaug BA; Ammash NM; Najam M; Bajwa N et al. Mechanism and risk factors for death in adults with tetralogy of Fallot. Am J Cardiol. 2019;124(5):803–807. https://doi.org/10.1016/j.amjcard.2019.05.048
(31) Becken B; Kilgore J; Thompson E; Moody MA. Right-sided endocarditis from Staphylococcus lugdunensis in a patient with tetralogy of Fallot. Infect Dis Rep. 2019;11(1):7872. https://doi.org/10.4081/idr.2019.7872
(32) Valente AM; Gauvreau K; Assenza GE; Babu-Narayan SV; Schreier J; Gatzoulis MA et al. Contemporary predictors of death and sustained ventricular tachycardia in patients with repaired tetralogy of Fallot enrolled in the INDICATOR cohort. Heart. 2014;100(3):247-253. https://doi.org/10.1136/heartjnl-2013-304958
(33) Altamirano-Diaz L; Norozi K; Seabrook JA; Welisch E. Lack of access to paediatric cardiology services in the public health system in four major urban centres in Perú. Cardiol Young. 2018;28(12):1452-1456. https://doi.org/10.1017/S1047951118001555
(34) Silva LS; Viegas SMF; Menezes C; Nascimento LC; Nitscke RG; Duarte DC. Demanda espontânea e acesso no Sistema Único de Saúde: vivências de usuários da atenção primária. Av Enferm. 2021;39(1):30-39. https://doi.org/10.15446/avenferm.v39n1.85573
(35) Heinisch PP; Guarino L; Hutter D; Bartkevics M; Erdoes G; Eberle B et al. Late correction of tetralogy of Fallot in children. Swiss Med Wkly. 2019;149(2728):w20096. https://doi.org/10.4414/smw.2019.20096
(36) Shackleford J; Chambers R; Nelson J; Scott M; Brasher S. Nurses’ perceptions of rooming-in for caregivers of infants with CCHD. J Pediatr Nurs. 2021;56:101-102. https://doi.org/10.1016/j.pedn.2020.08.008
(37) Foster CC; Steltzer M; Snyder A; Alden C; Helner K; Schinasi DA et al. Integrated multimodality telemedicine to enhance in-home care of infants during the interstage period. Pediatr Cardiol. 2021;42:349-360. https://doi.org/10.1007/s00246-020-02489-7
(38) Dean S; Long M; Ryan E; Tarnoviski K; Mondal A; Lisanti AJ. Assessment of an educational tool for pediatric cardiac nurses on individualized family-centered developmental care. Crit Care Nurse. 2021;41(2):e17-e27. https://doi.org/10.4037/ccn2021213

Tetralogia de Fallot em crianças e adolescentes do Nordeste brasileiro: um estudo descritivo

Tetralogy of Fallot in children and adolescents in northeastern Brazil: A descriptive study

Tetralogía de Fallot en niños y adolescentes del nordeste de Brasil: un estudio descriptivo

Resumen

Abstract

Resumo

Bibliography