Congenital heart disease in 111 225 births in Belgium: birth prevalence, treatment and survival in the 21st century

Moons, Philip; Sluysmans, Thierry; Wolf, Daniël De; Massin, Martial; Suys, Bert; Benatar, Abraham; Gewillig, Marc

doi:10.1111/j.1651-2227.2008.01152.x

Cited by 167 publications

(141 citation statements)

References 30 publications

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“…A study from Belgium 5 reported an incidence of 8.3% in live and stillborn infants of ≥26 weeks of gestation without chromosome abnormalities. There is likely an even higher incidence in early gestation given spontaneous and elective pregnancy termination.…”

Section: Indications For Referral For Fetal Cardiac Evaluationmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

979

543

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Background— The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and management of fetal cardiovascular disease. Methods and Results— A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence for practice guidelines were applied to the current practice of fetal cardiac medicine. Recommendations relating to the specifics of fetal diagnosis, including the timing of referral for study, indications for referral, and experience suggested for performance and interpretation of studies, are presented. The components of a fetal echocardiogram are described in detail, including descriptions of the assessment of cardiac anatomy, cardiac function, and rhythm. Complementary modalities for fetal cardiac assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin–twin transfusion syndrome, lung masses, and vascular tumors, are highlighted. Catheter-based intervention strategies to prevent the progression of disease in utero are also discussed. Recommendations for delivery planning strategies for fetuses with congenital heart disease including models based on classification of disease severity and delivery room treatment will be highlighted. Outcome assessment is reviewed to show the benefit of prenatal diagnosis and management as they affect outcome for babies with congenital heart disease. Conclusions— Fetal cardiac medicine has evolved considerably over the past 2 decades, predominantly in response to advances in imaging technology and innovations in therapies. The diagnosis of cardiac disease in the fetus is mostly made with ultrasound; however, new technologies, including 3- and 4-dimensional echocardiography, magnetic resonance imaging, and fetal electrocardiography and magnetocardiography, are available. Medical and interventional treatments for select diseases and strategies for delivery room care enable stabilization of high-risk fetuses and contribute to improved outcomes. This statement highlights what is currently known and recommended on the basis of evidence and experience in the rapidly advancing and highly specialized field of fetal cardiac care.

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Section: Indications For Referral For Fetal Cardiac Evaluationmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

979

543

View full text Add to dashboard Cite

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“…Indeed, perinatal mortality is already as high as 50% in hypoplastic left heart syndrome 22 and is Ϸ40% in univentricular heart. 11 The information obtained in the present study not only is important for estimating survival into adulthood for youngsters with CHD living today but also may be useful for future workforce planning. About a decade ago, Wren and O'Sullivan 23 used the estimated survival data available to calculate the need for follow-up in adult life.…”

Section: Discussionmentioning

confidence: 99%

“…14 Thus, nearly all patients with CHD in Belgium have been evaluated by pediatric cardiology or adult CHD programs, which are all located in university hospitals. On the basis of an epidemiological study comprising 111 225 births in Belgium, 11 we calculated that 27% of all patients with CHD in Belgium are diagnosed, treated, and followed up at the University Hospitals Leuven. Hence, we believe that the results of this study are fairly representative of the population of CHD patients in Western societies.…”

Section: Methodological Issuesmentioning

confidence: 99%

“…This center follows up Ϸ27% of all patients born with CHD in Belgium. 11 The center uses a common database that contains the records of all individuals examined, treated, and followed up at the center. The database comprises demographic information (date of birth, gender, home address, and treating physicians) and clinical information (type of heart defect, noncardiac diagnoses, cardiac interventions, date of death, date of last follow-up, etc).…”

Section: Setting and Data Sourcementioning

confidence: 99%

“…13 Modifications were based on its use in a recent epidemiological study in Belgium. 11 To classify patients by the complexity of their heart defect, we used the categories outlined by Task Force 1 of the 32nd Bethesda Conference: mild-, moderate-, or severecomplexity heart lesions. 5 Pulmonary arterial hypertension was defined as a mean pulmonary arterial pressure Ͼ25 mm Hg on cardiac catheterization.…”

Section: Measurements and Definitionsmentioning

confidence: 99%

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Temporal Trends in Survival to Adulthood Among Patients Born With Congenital Heart Disease From 1970 to 1992 in Belgium

et al. 2010

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Background-Over the past decades, the life expectancy of individuals with congenital heart disease (CHD) has increased significantly. However, precise estimates for survival to adulthood are scarce for patients with CHD. We investigated the proportion of CHD patients born between 1990 and 1992 who survived into adulthood. We also compared their survival with that of CHD patients born in earlier eras and evaluated survival as a function of the type of heart defect.

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