Reliability of Fetal Echocardiography in Predicting Postnatal Critical Hypoxia in Patients with Transposition of Great Arteries and Intact Ventricular Septum
| Autor: | M Bonito, Alessandra Toscano, L. Di Chiara, Tarek Alsaied, Pietro Bagolan, R Formigari, M. Masci, A. Romiti, Luciano Pasquini, Lorenzo Galletti, C. M. Campanale |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Prenatal diagnosis 030204 cardiovascular system & hematology Balloon dextro-Transposition of the great arteries medicine.disease Cardiac surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030228 respiratory system Great arteries Internal medicine Pediatrics Perinatology and Child Health medicine Cardiology Septum primum Cardiology and Cardiovascular Medicine business Fetal echocardiography Interatrial septum |
| Zdroj: | Pediatric Cardiology. 42:1575-1584 |
| ISSN: | 1432-1971 0172-0643 |
| DOI: | 10.1007/s00246-021-02642-w |
| Popis: | Critical hypoxemia soon after birth is the most critical preoperative determinant of neurological outcomes and survival in newborns with Dextro Transposition of the Great Arteries and Intact Ventricular Septum (D-TGAIVS). Our study aimed to define fetal echocardiographic aspects that can better predict neonates with D-TGAIVS at risk for restricted interatrial communication after birth. 31 fetuses with a prenatal diagnosis of D-TGAIVS were included in our study. We divided patients with D-TGAIVS according to the timing of balloon atrial septostomy: Urgent, Not-Urgent and no BAS. We identified five fetal echocardiographic aspects of the interatrial septum (redundant, aneurysmal, flat, fixed, hypermobile). No significant differences in these fetal echocardiographic features were found between the three different groups of D-TGAIVS according to the timing of balloon atrial septostmy. However, only two patients showed flat appearance of interatrial communication: both needed Urgent balloon atrial septostomy. The prevalence of hypermobile septum primum was significantly lower in the control group compared to patients with D-TGAIVS. Fetal echocardiographic aspects cannot predict patients with D-TGAIVS who will not need Urgent balloon atrial septostomy. Therefore, we recommended a delivery in a tertiary center, equipped for Urgent balloon atrial septostomy, for all patients with D-TGAIVS regardless of fetal echocardiographic features. |
| Databáze: | OpenAIRE |
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