Cardiology in the Young

Brief Reports

Prenatal complex congenital heart disease with Loeys–Dietz syndrome

Yukiko Kawazua1 c1, Noboru Inamuraa1, Futoshi Kayatania1, Nobuhiko Okamotoa2 and Hiroko Morisakia3

a1 Department of Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan

a2 Department of Medical Genetics, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan

a3 Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan

Abstract

We report an infantile case of Loeys–Dietz syndrome prenatally diagnosed with congenital complex heart disease – double outlet right ventricle and interruption of the aortic arch. The patient also showed prominent dilatation of the main pulmonary artery. Emergency bilateral pulmonary artery banding was performed on the 9th day. However, on the 21st day, the patient died of massive bleeding due to rupture of the right pulmonary artery. Subsequently, a mutation of the TGFBR1 gene was detected. As cardiovascular lesions of Loeys–Dietz syndrome appear early and progress rapidly, the prognosis is generally poor. Patients require periodic examination and early intervention with medical therapy such as Losartan administration and surgical therapy. Early genetic screening is thought to be useful for the prediction of complications as well as vascular disease.

(Received January 25 2011)

(Accepted May 25 2011)

(Online publication July 21 2011)

Correspondence:

c1 Correspondence to: Y. Kawazu, MD, PhD, 840 Murodo-cho Izumi-city, Osaka 594-1101, Japan. Tel: +81 725 56 1220; Fax: +81 725 56 1858; E-mail: kadoy@mch.pref.osaka.jp