Three year experience of a clinical cardiovascular genetics program for infants with congenital heart disease.
OBJECTIVE
To describe the first 3 years of experience of having an inpatient "cardiogenetics" program which involves medical geneticist assessment of infants with major congenital heart disease (CHD) requiring surgical intervention in the first year of life.


PATIENTS
Patients less than a year of age admitted to Children's Hospital of Wisconsin's Herma Heart Institute for surgical intervention for CHD seen by the cardiogenetics program. Patients with major trisomies (13, 18, and 21) were excluded.


OUTCOME MEASURES
Utilization and yield of genetic testing, and diagnostic rate were assessed as outcome measures and compared to a baseline time period and a genetic testing protocol time period.


RESULTS
There were 201 infants with CHD evaluated by the cardiogenetics program over 3 years. A total of patients 46 patients of the 196 who underwent genetic testing had multiple tests completed. This is a significant decrease from the baseline (247/329, P < .0001) and from the genetic testing protocol (29/81, P < .0387) time periods. The diagnostic rate was 33% which is significantly increased compared to the baseline rate of 15% (80/524, P < .0001) and trends toward a significant increase during the testing protocol rate (25/113, P = .0520). The number of dual diagnosis increased to 9 of 201 compared to the baseline (2/524) and the genetic testing protocol (1/113) time periods. The rate of incidental diagnoses altering care increased to 6 of 201 from the baseline (1/524) and the genetic testing protocol (1/113) time periods.


CONCLUSION
An inpatient cardiogenetics program significantly increases the diagnostic rate, the detection of complex phenotypes with dual diagnoses, the identification of incidental genetic diagnoses associated with changes in care, and significantly decreases the likelihood of multiple tests being completed on an individual patient. Increased medical geneticist involvement in programs that care for infants with CHD should be encouraged to improve patient care and genetic testing utilization.
['Geddes|Gabrielle C|GC|https://orcid.org/0000-0003-2077-4997', 'Syverson|Erin|E|', 'Earing|Michael G|MG|']
D005260:Female D005500:Follow-Up Studies D005820:Genetic Testing D006330:Heart Defects, Congenital D006801:Humans D007223:Infant D007297:Inpatients D008297:Male D010641:Phenotype D015397:Program Evaluation D012189:Retrospective Studies D013997:Time Factors
cardiovascular genetics congenital heart disease genetic testing