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FISH for 22q11.2 Deletion Not Cost-Effective for Infants with Congenital Heart Disease with Microarray.
[22q11.2 deletion syndrome]
The
objective
of
this
study
is
to
evaluate
the
yield
of
genetic
testing
in
infants
with
congenital
heart
disease
,
who
undergo
surgical
intervention
prior
to
one
year
of
age
,
and
develop
a
cost-effective
strategy
to
screen
infants
with
congenital
heart
disease
for
genetic
conditions
while
providing
standard
of
care
.
409
charts
of
patients
with
congenital
heart
disease
,
who
underwent
surgical
intervention
prior
to
one
year
of
age
,
were
retrospectively
reviewed
for
cytogenetic
testing
results
.
278
patients
underwent
cytogenetic
testing
,
and
89
.
6
Â
%
of
these
patients
had
more
than
one
cytogenetic
test
completed
.
The
most
commonly
encountered
chromosomal
anomaly
within
the
sample
was
Down
Syndrome
(
12
.
5
Â
%
)
,
followed
by
22
q
11
.
2
Deletion
Syndrome
(
4
.
6
Â
%
)
.
G-Banded
Karyotypes
were
abnormal
in
10
.
5
Â
%
of
patients
,
fluorescence
in
situ
hybridization
(
FISH
)
probe
for
22
q
11
.
2
deletion
was
abnormal
in
7
.
1
Â
%
of
patients
.
SNP
microarray
testing
showed
the
highest
yield
and
was
abnormal
in
33
Â
%
of
patients
.
Based
on
the
data
at
our
institution
,
a
more
directed
approach
of
genetic
screening
with
only
microarray
would
have
saved
our
institution
approximately
$
101
,
200
on
the
103
patients
who
underwent
genetic
evaluation
with
microarray
reviewed
.
Screening
infants
with
congenital
heart
disease
for
22
q
11
.
2
deletion
with
FISH
resulted
in
a
loss
of
approximately
$
32
,
000
per
100
patients
at
our
institution
.
Institutions
should
develop
microarray-based
protocols
for
genetic
screening
in
patients
with
congenital
heart
disease
with
the
anticipation
of
adding
lesion-
specific
single
gene
testing
as
single
gene
testing
becomes
routinely
available
.
Diseases
Validation
Diseases presenting
"lesion-specific single gene testing"
symptom
22q11.2 deletion syndrome
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