Pre-intervention morphologic and functional echocardiographic characteristics of neonates with critical left heart obstruction: a Congenital Heart Surgeons Society (CHSS) inception cohort study.
Aortic Valve Stenosis
/ congenital
Cardiac Surgical Procedures
/ methods
Cohort Studies
Echocardiography
/ methods
Female
Heart Defects, Congenital
/ diagnostic imaging
Humans
Hypoplastic Left Heart Syndrome
/ diagnostic imaging
Infant, Newborn
Male
Mitral Valve Stenosis
/ congenital
Prognosis
Rare Diseases
Retrospective Studies
Severity of Illness Index
Societies, Medical
Survival Analysis
Thoracic Surgery
Treatment Outcome
cardiac function
echocardiography
hypoplastic left heart syndrome
left ventricular outflow tract obstruction
neonate
Journal
European heart journal. Cardiovascular Imaging
ISSN: 2047-2412
Titre abrégé: Eur Heart J Cardiovasc Imaging
Pays: England
ID NLM: 101573788
Informations de publication
Date de publication:
01 Jun 2019
01 Jun 2019
Historique:
received:
15
05
2018
revised:
16
08
2018
accepted:
11
09
2018
pubmed:
20
10
2018
medline:
9
10
2020
entrez:
20
10
2018
Statut:
ppublish
Résumé
The aims of this study were to provide a detailed descriptive analysis of pre-intervention morphologic and functional echocardiographic parameters in a large, unselected, multicentre cohort of neonates diagnosed with critical left heart obstruction and to compare echocardiographic features between the different subtypes of left-sided lesions. Pre-intervention echocardiograms for 651 patients from 19 Congenital Heart Surgeons' Society (CHSS) institutions were reviewed in a core lab according to a standardized protocol including >150 morphologic and functional variables. The four most common subtypes of lesions were: aortic atresia (AA)/mitral atresia (MA) (29% of patients), AA/mitral stenosis (MS) (20%), aortic stenosis (AS)/MS (26%), and isolated AS (iAS) (18%). Only 17% of patients with AS/MS had an apex-forming left ventricle, compared with 0% of those with AA/MA and AA/MS (P < 0.0001). Aortic arch hypoplasia and coarctation were common across all four groups, while those with AA/MA and AA/MS had the smallest ascending aorta diameters. Flow in the ascending aorta was retrograde in 43% and 10% of the patients with AS/MS and iAS, respectively. The right ventricle was apex forming in 100% of patients with AA/MA and AA/MS, 96% with AS/MS and 70% with iAS (P < 0.0001). Moderate to severe tricuspid regurgitation was present in 13% of all patients. This large multi-institutional study generates insight into the distribution of the functional and morphologic spectrum in patients with critical left-sided heart disease and identifies differences in these functional and morphologic characteristics between the main anatomic subtypes of critical left heart obstruction.
Identifiants
pubmed: 30339206
pii: 5137108
doi: 10.1093/ehjci/jey141
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
658-667Informations de copyright
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.