Endocardial cushion defect natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

If left untreated, majority of patients with endocardial cushion defect may progress to develop life threatening conditions. Common complications of endocardial cushion defect include dilatation of heart, pulmonary hypertension, respiratory tract infections , and heart failure. Surgical mortality rate of patients with partial endocardial cushion defect is approximately 0.6%. For complete cushion defect the surgical mortality rate is 2.5-9%. Prognosis of endocardial cushion defect is generally good with treatment. However, some children might develop valvular and rhythm disorders after surgical correction.

Natural History

• If left untreated, majority of patients with endocardial cushion defect may progress to develop life threatening heart failure and pulmonary hypertension.

Complications

• Common complications of endocardial cushion defect include:
  • Dilatation of heart
  • Pulmonary hypertension
  • Respiratory tract infections
  • Heart failure

Prognosis

• Prognosis of endocardial cushion defect is generally good with treatment. However, some children might develop valvular and rhythm disorders after surgical correction.
• Prognositic factors include:
  • Degree of preoperative pulmonary vascular disease
  • Amount of residual AV valve regurgitation
• Protected pulmonary vascular bed with mild AV regurtiation is associated with good outcome, while the contrary holds the bad prognosis.
• Surgical mortality rate of patients with partial endocardial cushion defect is approximately 0.6%. For complete cushion defect the surgical mortality rate is 2.5-9%