Pulmonary venous Doppler patterns and midterm outcomes in fetuses with left-sided obstructive lesions and restrictive atrial septum.
Adult
Atrial Septum
/ diagnostic imaging
Cohort Studies
Female
Fetus
/ blood supply
Gestational Age
Heart Septal Defects, Atrial
/ diagnosis
Humans
Hypoplastic Left Heart Syndrome
/ diagnosis
Infant, Newborn
Pregnancy
Pregnancy Outcome
Pulmonary Veins
/ diagnostic imaging
Retrospective Studies
Ultrasonography, Doppler
/ methods
Ultrasonography, Prenatal
/ methods
Young Adult
Journal
Prenatal diagnosis
ISSN: 1097-0223
Titre abrégé: Prenat Diagn
Pays: England
ID NLM: 8106540
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
09
12
2019
revised:
29
02
2020
accepted:
04
03
2020
pubmed:
17
3
2020
medline:
14
7
2021
entrez:
17
3
2020
Statut:
ppublish
Résumé
To compare length of stay of the initial neonatal hospitalization and mortality across multiple stages of surgical palliation for infants with left-sided obstructive lesions and severely restrictive or intact atrial septum (I/RAS). Retrospective cohort study of patients prenatally diagnosed with left-sided obstructive lesions and I/RAS, defined by fetal pulmonary venous Dopplers. We identified 76 fetal patients with 59 live born intending to pursue intervention. Those with I/RAS had longer durations of mechanical ventilation (P = .031) but no difference in intensive care unit or total length of stay. Survival to discharge from neonatal hospitalization was 41.7% in the I/RAS group and 80.7% in the unrestrictive group (P = .001). There was a higher proportion of deaths between stage 1 and stage 2 in the I/RAS group - 5/9 (55.6%) vs 9/50 (18%) in the unrestrictive group (P = .027). Beyond stage 2 palliation there was trend toward a difference in overall mortality (66.7% in I/RAS vs 35.7% in unrestrictive, P = .05) but no statistically significant difference in transplant-free survival (33.3% in I/RAS vs 53.5% in unrestrictive, P = .11). The survival disadvantage conferred by prenatally diagnosed severe atrial septal restriction is most pronounced in the neonatal and early infancy period, with no detectable difference in late midterm transplant-free survival in our cohort.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
776-784Informations de copyright
© 2020 John Wiley & Sons, Ltd.
Références
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