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Closure of a large perimembranous ventricular septal defect in a 4.8Â kg baby with Down syndrome using a duct occluder.
[hirschsprung disease]
A
9
.
5
-
month
-old
boy
with
Down
syndrome
,
weighing
4
.
8
Â
kg
,
presented
with
history
of
failure
to
thrive
.
Clinically
,
he
had
symptoms
and
signs
of
congestive
heart
failure
.
His
echocardiogram
showed
a
large
perimembranous
ventricular
septal
defect
(
pmVSD
)
with
some
inlet
extension
covered
by
a
large
aneurysmal
tissue
with
multiple
right
ventricular
(
RV
)
exits
.
Additionally
,
he
had
hypothyroidism
and
Hirschsprung
disease
.
Instead
of
closing
the
VSD
surgically
,
the
VSD
was
successfully
closed
utilizing
an
8
Â
×
Â
6
Â
mm
duct
occluder
.
The
baby
remained
in
the
intensive
care
unit
for
one
night
.
The
day
after
the
procedure
,
the
infant
was
stable
and
showed
clinical
improvement
.
Electrocardiogram
(
ECG
)
showed
normal
sinus
rhythm
with
no
evidence
of
heart
block
.
Twenty
-
four
hours
later
,
echocardiography
showed
the
device
was
in
an
excellent
position
,
with
a
small
residual
leak
.
There
was
normal
tricuspid
valve
inflow
and
normal
aortic
valve
outflow
with
no
significant
valvar
insufficiency
.
The
baby
was
discharged
after
3
Â
days
in
stable
condition
.
We
believe
infants
with
such
co
-morbidities
which
might
complicate
their
post-operative
course
and
prolong
the
intensive
care
unit
admission
,
might
benefit
from
such
alternative
management
.
Diseases
Validation
Diseases presenting
"failure to thrive"
symptom
22q11.2 deletion syndrome
alexander disease
child syndrome
congenital diaphragmatic hernia
cystinuria
familial hypocalciuric hypercalcemia
hirschsprung disease
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
krabbe disease
neonatal adrenoleukodystrophy
omenn syndrome
papillon-lefèvre syndrome
pyruvate dehydrogenase deficiency
triple a syndrome
wolf-hirschhorn syndrome
zellweger syndrome
This symptom has already been validated