In fetuses with congenital lung masses, decreased ventricular and atrioventricular valve dimensions are associated with lesion size and clinical outcome

Autor: Christopher Mardy, Safwan Halabi, Erika Rubesova, Alisa Arunamata, Karl G. Sylvester, Shiraz A. Maskatia, Susan R. Hintz, Yair J. Blumenfeld, Anna I. Girsen, Theresa A. Tacy
Rok vydání: 2019
Předmět:
Heart Defects
Congenital
Lung Diseases
0301 basic medicine
medicine.medical_specialty
Cardiac output
Heart disease
Hydrops Fetalis
medicine.medical_treatment
Gestational Age
030105 genetics & heredity
Ultrasonography
Prenatal
Lesion
03 medical and health sciences
Extracorporeal Membrane Oxygenation
Fetal Heart
0302 clinical medicine
Pregnancy
Internal medicine
Intubation
Intratracheal
medicine
Extracorporeal membrane oxygenation
Humans
Cardiac Output
Genetics (clinical)
Pulmonary Valve
Atrioventricular valve
030219 obstetrics & reproductive medicine
Lung
business.industry
Infant
Newborn
Obstetrics and Gynecology
Congenital pulmonary airway malformation
Gestational age
Stroke Volume
Organ Size
medicine.disease
Heart Valves
Magnetic Resonance Imaging
Respiration
Artificial
medicine.anatomical_structure
Echocardiography
Aortic Valve
Cardiology
Mitral Valve
Female
Tricuspid Valve
medicine.symptom
business
Zdroj: Prenatal Diagnosis. 40:206-215
ISSN: 1097-0223
0197-3851
DOI: 10.1002/pd.5612
Popis: INTRODUCTION The clinical importance of mass effect from congenital lung masses on the fetal heart is unknown. We aimed to report cardiac measurements in fetuses with congenital lung masses and to correlate lung mass severity/size with cardiac dimensions and clinical outcomes. METHODS Cases were identified from our institutional database between 2009 and 2016. We recorded atrioventricular valve (AVVz) annulus dimensions and ventricular widths (VWz) converted into z scores, ratio of aortic to total cardiac output (AoCO), lesion side, and congenital pulmonary airway malformation volume ratio (CVR). Respiratory intervention (RI) was defined as intubation, extracorporeal membrane oxygenation (ECMO), or use of surgical intervention prior to discharge. RESULTS Fifty-two fetuses comprised the study cohort. Mean AVVz and VWz were below expected for gestational age. CVR correlated with ipsilateral AVVz (RS = -.59, P < .001) and ipsilateral VWz (-0.59, P < .001). Lower AVVz and AoCO and higher CVR were associated with RI. No patient had significant structural heart disease identified postnatally. CONCLUSION In fetuses with left-sided lung masses, ipsilateral cardiac structures tend to be smaller, but in our cohort, there were no patients with structural heart disease. However, smaller left-sided structures may contribute to the need for RI that affects a portion of these fetuses.
Databáze: OpenAIRE
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