Prenatal Detection, Comorbidities, and Management of Vascular Rings
| Autor: | Lisa K. Hornberger, Deborah Fruitman, Aisling A. Young, Edythe B Tham, Kim Haberer, Angela McBrien, Lindsay Mills, Michelle Noga |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Heart Defects
Congenital Male medicine.medical_specialty Adolescent Population Magnetic Resonance Imaging Cine Prenatal diagnosis 030204 cardiovascular system & hematology Ultrasonography Prenatal 03 medical and health sciences 0302 clinical medicine Bronchoscopy Pregnancy Internal medicine Medicine Humans Abnormalities Multiple Cardiac Surgical Procedures education Child Retrospective Studies education.field_of_study 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Obstetrics Infant Newborn Vascular ring Disease Management Infant Retrospective cohort study medicine.disease Vascular Ring Echocardiography Child Preschool Cohort Cardiology Female Ultrasonography Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The American journal of cardiology. 123(10) |
| ISSN: | 1879-1913 |
| Popis: | The 3-vessel and trachea view is now integrated into obstetrical screening and facilitates prenatal detection of vascular rings. We examined trends in prenatal detection, associated cardiac and extracardiac anomalies, and surgical management in this population. We reviewed a population-based cohort of pediatric vascular ring patients diagnosed prenatally and postnatally between 2002 and 2017 in Alberta, Canada. Of 106 cases, 28 (26%) had a prenatal diagnosis. Prenatal detection increased over time: 0/29 from 2002 to 2009, 4/28 (14%) from 2009 to 2011, 7/23 (30%) from 2012 to 2014, and 17/26 (65%) from 2015 to 2017 (p0.01). The prenatal group more commonly had right aortic arch/left ductus/aberrant left subclavian artery (24/28vs 53/78, p = 0.04) and associated cardiac pathology (18/28vs 33/78, p = 0.05). The rate of genetic anomalies was overall higher than previously reported (34%) and did not differ between groups (11/28vs 25/78, p = 0.48). Those with a prenatal diagnosis were less likely to require cross-sectional imaging (9/28vs 48/78, p0.01), modifying the vascular ring subtype diagnosis in 2 patients. Surgical intervention was common and did not differ between groups (24/28vs 66/78, p = 0.89). In conclusion, prenatal detection of vascular rings has increased. Despite differences in vascular ring subtype and associated cardiac pathology, the incidence of genetic anomalies and need for surgical intervention is not associated with timing of diagnosis. Genetic counseling should be universally offered. The diagnostic accuracy of echocardiography suggests additional imaging may not be routinely required. |
| Databáze: | OpenAIRE |
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