Unraveling Unique Prevalence Patterns: Localized Insights into Associated Cardiac Anomalies in Anorectal Malformation Populations

Background: Anorectal malformation (ARM) is a congenital condition affecting the development of the rectum and anus. Brunei exhibits a notably higher incidence of ARM compared to the global average, prompting a closer examination of associated cardiac anomalies (CAs). Methods: A retrospective observational study (2016-2022) at Brunei's tertiary care centre reviewed ARM cases, emphasizing the identification of associated CAs and their clinical impact. Results: Among 34 cases, 18% demonstrated concurrent CAs and only half of these were significant, necessitating cardiac intervention. These CAs were predominantly associated with low-type ARMs. Patent ductus arteriosus (PDA) and ventricular septal defects (VSD) were the most prevalent associated cardiac anomalies. Attributed cardiac mortality was noted in 1 case. Conclusion: Our study provides unique insights into co-occurring cardiac anomalies in Bruneian ARM cases. Deviations from global averages prompt revaluation of clinical approaches. The lower incidence of interventions suggests a distinct clinical scenario, highlighting the importance of localized studies in managing ARM cases in this specific population. The study also emphasizes the need for cautious consideration of routine echocardiograms for all ARM cases.