Complete attrioventricular canal in a child with Down syndrome

Abstract

Introduction.The complete atrioventricular canal (CAVC) is a rare complex heart malformation, it constitutes 4-5% of the total heart abnormalities and in 30-60% it is associated with Down syndrome. Arrhythmias are often associated with CAVC. The presence of the genetic syndrome conditions the surgical correction in the first months of life.Purpose.Identifying rhythm and conduction disorders in a child with CAVC.Material and methods.Anamnestic, clinical and paraclinical data were taken from the medical record. The patient was investigated by electrocardiography (ECG), M, B and color Doppler echocardiography (EcoCg), cardiovascular radiology. Literature on similar cases has been studied. Results.The 8-month-old girl, with CAVC and associated Down syndrome, was hospitalized in the pediatric cardiology service for evaluation after cardiac surgery. The complexity of the abnormality and the association of Down syndrome determined the radical correction to be performed at the age of 6 months, in a single stage, in accordance with the recommendations of the current guidelines. Postoperatively, after 2 months, a relatively good result of the operation was confirmed. On standard ECG, a sinus rhythm and intraventricular combined conduction disorders were found, such as complete right bundle branch block and left anterior fascicular block of the His bundle, clinically insignificant arrhythmia.Conclusions.Analyzing the case, we deduced that the conduction disorders detected on the standard ECG are arrhythmic complications after corrective surgery, with damage to the transient intraventricular conduction system, with minor clinical impact.