Prenatal Maternal Hyperoxygenation Testing and Implications for Critical Care Delivery Planning among Fetuses with Congenital Heart Disease: Early Experience

2017 ◽  
Vol 35 (01) ◽  
pp. 016-023 ◽  
Author(s):  
Mary Donofrio ◽  
David Schidlow
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Care Delivery ◽  
Perinatal Outcomes ◽  
Atrial Septum ◽  
Fetal Ultrasound ◽  
Ebstein Anomaly ◽  
Intact Atrial Septum ◽  
Vertical Vein

Background Maternal hyperoxygenation (MH) during fetal ultrasound can characterize fetal pulmonary vasoreactivity (PVr) and its associations with postnatal physiology. Objective We explored MH testing to facilitate perinatal risk stratification for fetuses with congenital heart disease (CHD). Methods MH was performed in 12 fetuses: 2 with Ebstein anomaly, 2 with total anomalous pulmonary venous connection (TAPVC), 4 with hypoplastic left heart syndrome (HLHS) with (a) restrictive atrial septum (RAS) or (b) intact atrial septum (IAS) with decompressing vertical vein (VV), and 4 with D-loop transposition of the great arteries (TGA). PVr and physiologic and anatomic changes with MH and outcomes were recorded. Results Among Ebstein fetuses, pulmonary blood flow with MH mirrored postnatal findings. Among TAPVC fetuses, MH VV gradients correlated with postnatal gradients. One HLHS/IAS/VV fetus had no PVr and decreased pulmonary vein forward to reverse velocity time integral ratio with MH. Shortly after delivery, the infant experienced severe low cardiac output and required urgent atrial septoplasty. The remaining HLHS fetuses had PVr and underwent routine Stage 1 Norwood. Among TGA fetuses, septum primum position, foramen ovale flow, and the presence or absence of PVr with MH reflected postnatal findings. Conclusion MH may help identify fetuses with CHD at risk for perinatal compromise. Additional study may yield insights into fetal PVr and elucidate predictors of perinatal outcomes.

Radiofrequency-assisted atrial septoplasty for an intact atrial septum in complex congenital heart disease

2002 ◽  
Vol 56 (3) ◽  
pp. 412-415 ◽  
Author(s):  
Gideon J. Du Marchie Sarvaas ◽  
Kalyani R. Trivedi ◽  
Lisa K. Hornberger ◽  
K. Jin Lee ◽  
Joel A. Kirsh ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Atrial Septum ◽  
Complex Congenital Heart Disease ◽  
Intact Atrial Septum

Efficacy of Routine Fetal Ultrasound Screening for Congenital Heart Disease in Normal Pregnancy

Circulation ◽  
1996 ◽  
Vol 94 (1) ◽  
pp. 67-72 ◽  
Author(s):  
E. Buskens ◽  
D.E. Grobbee ◽  
I.M.E. Frohn-Mulder ◽  
P.A. Stewart ◽  
R.E. Juttmann ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Normal Pregnancy ◽  
Ultrasound Screening ◽  
Fetal Ultrasound

Perinatal outcomes of pregnancies with prenatally diagnosed foetal congenital heart disease

2022 ◽  
pp. 1-6
Author(s):  
Riza Madazlı ◽  
Ebru Alıcı Davutoglu ◽  
Verda Alpay ◽  
Didem Kaymak ◽  
Hakan Erenel ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Perinatal Outcomes

scholarly journals P879 3D transoesophageal echocardiography to asses a case of a non-ebstein tricuspid valve congenital regurgitation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I Sanz Ortega ◽  
S Velasco Del Castillo ◽  
J J Onaindia Gandarias ◽  
I Rodriguez Sanchez ◽  
J Florido Perena ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Congenital Heart ◽  
Volume Overload ◽  
Transoesophageal Echocardiography ◽  
Ebstein Anomaly ◽  
Downward Displacement ◽  
And Function

Abstract Introduction Due to the complexity of congenital heart disease and limitations of transthorathic echocardiogram (TTE), especially in adult patients, it is not unusual to need other image techniques to assess cardiac anatomy and function. The most common primary anomaly of tricuspid valve (TV) is Ebstein anomaly, but there are other much rarer primary anomalies of this valve consisting in prolapse, cord retraction.... without downward displacement of the leaflet, generally causing tricuspid regurgitation (TR) that can be severe and sometimes intervention is needed, preferably reparation. Due to anatomical issues, it is difficult to assess anatomy of TV in TTE, so sometimes 3D-TTE must be performed to clarify the mechanism and to measure orifice, but when transthoracic view is not enough, 3D transoesophageal echocardiogram (TOE) can be useful for this purpose. Case We report the case of a 15-year-old boy that was referred to our clinic because of shortness of breath and a systolic tricuspid murmur. TTE was performed and an image compatible with tricuspid valve prolapse with no apical displacement of any leaflets (Figure, A) causing severe TR (Figure, B) was noticed, as well as severely dilated right chambers, with good ejection fraction of both ventricles. It was not clear the mechanism so 2D TOE was done, showing a prolapse of a leaflet (Figure, C) causing severe TR (Figure, D). The mechanism was finally clarified by 3D TOE (figure E). This was a prolapse of lateral portion of posterior leaflet (asterisk) with restrictive movement of anterior (triangle) and septal (arrow) ones, causing a huge coaptation defect in systole leading to a very severe tricuspid insufficiency with signs of volume overload of right ventricle. There was no atrial septal defect and pulmonary drainage anomalies were ruled out by cardiac magnetic resonance. Patient was referred to surgery due to symptoms and great dilatation of right chambers. Conclusión: Due to anatomical complexity and limitations of echography, cross and multimodality cardiac imaging is usually needed in assessing congenital heart disease. Apart from Ebstein anomaly, other congenital entities of tricuspid valve such as prolapse and/or retraction can lead to severe tricuspid regurgitation. Due to limitations of 2D TTE in assessing tricuspid valve anatomy, 3D TTE has to be performed, but if it is not enough, 3D TOE can be an option to evaluate mechanism and directly see the orifice of regurgitation in congenital disease of tricuspid valve. Abstract P879 Figure

scholarly journals Ectopia cordis: a case report

2014 ◽  
Vol 14 (3) ◽  
pp. 287-290 ◽  
Author(s):  
Gonçalo Filipe Infante Mesquita Dias ◽  
Ana Vanessa dos Reis Santos ◽  
Cátia Filipa Cabrita Paixão Martins ◽  
Ana Paula Duarte Ferreira ◽  
Joaquim Marques Dinis da Fonseca
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Fetal Echocardiography ◽  
Anterior Chest Wall ◽  
Personal History ◽  
Pathological Examination ◽  
Fetal Ultrasound ◽  
Ectopia Cordis ◽  
Severe Congenital Heart Disease

Introduction: ectopia cordis is a rare congenital malformation, with an estimated incidence of 5 to 8 per million live births. It is defined as a malformation in which the heart is located in an extra-thoracic position. Ectopia cordis may occur as an isolated malformation or associated with other anomalies such as omphalocele, congenital heart disease or integrating Cantrell syndrome. The size and location of the defect influence the prognosis. Description: we report a case of a 24-year-old nulliparous woman, with no relevant family or personal history, in which the prenatal fetal ultrasound, performed at 21 weeks of gestation, revealed adefect of the anterior chest wall with exteriorization of the heart. Discussion: fetal echocardiography revealed a severe congenital heart disease. The parents decided to continue the pregnancy, after being duly informed by a multidisciplinary team. Delivery occurred at 37 weeks of gestation but the female newborn died one hour afterwards. Pathological examination confirmed the sonographic findings.

Sign in / Sign up

Export Citation Format

Share Document