Do infants with transposition of the great arteries born outside a specialist centre have different outcomes?

Veal, Colin; Hunt, Richard C.; Tume, Lyvonne N

doi:10.1017/s1047951119001367

Cited by 4 publications

(1 citation statement)

References 27 publications

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“…Moreover, the total cost of initial hospitalization is higher for infants without a prenatal diagnosis of D-TGA [25]. It was also observed that if D-TGA is detected prenatally, there are no differences in postnatal outcomes, independent of whether a neonate was delivered in a specialist centre or a primary hospital [26].…”

Section: Discussionmentioning

confidence: 96%

The role of first-trimester single arterial vessel sign instead of a V-sign at the level of the three-vessel and tracheal view in screening for congenital heart diseases

Nocuń,

Wiecheć,

Dudzik

et al. 2023

pcard

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Introduction: Despite efforts from dedicated societies, prenatal detection rates (DRs) of congenital heart diseases (CHDs) remain unsatisfactory. Early cardiac scan is believed to play an important role in selecting fetuses for further assessment and to improve the DRs. The aims of the study were to compare first-trimester cardiac parameters and follow-up fetal, postnatal echocardiography and autopsy findings in fetuses presenting the single arterial vessel with fetuses presenting the "V-sign" at the level of the 3 vessels and trachea view in colour mapping (3VTVc), and to measure screening performance of the single arterial vessel in 3VTV for D-TGA and D-TGA+VSD, all CHDs, and ductal-dependent (DD) CHDs. Material and methods: This study was a prospective observational analysis that covered 2338 pregnancy referrals. Study protocol included an early fetal echocardiography approach to the 4-chamber view in colour mapping and 3VTVc. Results: Among single arterial vessel fetuses 2 normal hearts, 66 CHDs, including 42 DD lesions, were identified; and among "V-sign" fetuses, 1913 normal hearts, 42 CHDs, including 2 DD lesions. The single arterial vessel sign was highly sensitive (93.3%) and specific (97.3%) for D-TGA/D-TGA+VSD at the time of the early cardiac scan. Moreover, the single arterial vessel in 3VTV was highly sensitive (95.8%) and specific (98.8%) for other ductal-dependent CHDs. Conclusions: Differentiation between the single arterial vessel sign in 3VTV and the "V-sign" is replicable and safe due to the short exposure time for colour mapping needed to obtain satisfactory images. This would help establish their use as another strong prenatal predictor of important congenital heart disease, D-TGA, and other DD-lesions.

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Section: Discussionmentioning

confidence: 96%

The role of first-trimester single arterial vessel sign instead of a V-sign at the level of the three-vessel and tracheal view in screening for congenital heart diseases

Nocuń,

Wiecheć,

Dudzik

et al. 2023

pcard

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Transport of the Surgical Neonate

Rolle

Puri

2023

Pediatric Surgery

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Timing of Balloon Atrial Septostomy in Patients with d-TGA and Association with Birth Location and Patient Outcomes

Thomas

Lowery

et al. 2022

Pediatr Cardiol

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Patients with d-looped transposition of the great arteries (d-TGA), especially those without an adequate atrial septal defect, can experience severe hypoxemia and hemodynamic compromise in the neonatal period. This can be mitigated by urgent balloon atrial septostomy (BAS). However, some patients with d-TGA are born at centers without this capability. The aim of this retrospective study of d-TGA patients who had urgent or emergent BAS at our institution between 2010 and 2021 was to evaluate time from birth to BAS for infants born at a tertiary care center as compared to those requiring transport from other institutions and to examine correlation between time to BAS and patient outcomes. Our primary outcome was time from birth to BAS. Secondary outcomes included hospital and ICU length of stay, mortality, and evidence of pulmonary or neurologic abnormalities including pulmonary hypertension, abnormal neuroimaging, or seizures. Of 96 patients, 67 (70%) were born at our institution. The median time to BAS was 4 hours for patients born at our institution vs. 14.1 hours for those born elsewhere (p < .0001). A longer time from birth to BAS was associated with longer ICU (r = 0.21, p = 0.046) and hospital length of stay (r = 0.24, p = 0.02) and increased likelihood of elevated right ventricular pressure on post-operative discharge echocardiogram (p = 0.01). There were no differences in mortality between the groups. Therefore, prenatal planning for patients with known d-TGA should include a delivery plan with access to urgent BAS.

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Do infants with transposition of the great arteries born outside a specialist centre have different outcomes?

Cited by 4 publications

References 27 publications

The role of first-trimester single arterial vessel sign instead of a V-sign at the level of the three-vessel and tracheal view in screening for congenital heart diseases

The role of first-trimester single arterial vessel sign instead of a V-sign at the level of the three-vessel and tracheal view in screening for congenital heart diseases

Transport of the Surgical Neonate

Timing of Balloon Atrial Septostomy in Patients with d-TGA and Association with Birth Location and Patient Outcomes

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