Head Biometry in Fetuses with Isolated Congenital Heart Disease

Graupner, O; Koch, Jessica; Enzensberger, C; Götte, M; Wolter, A; Müller, V; Kawecki, A; Herrmann, Jens; Axt-Fliedner, R

doi:10.1055/a-0893-7484

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…The majority of these cases were detected by fetal echocardiography prompted by hydrops fetalis, but the precise diagnosis of ALVT could only be achieved based on postnatal echocardiography or autopsy. As standards of the second-trimester scan have been established in the past decades, prenatal detection rates of structural heart defects, such as ALVT, may have improved 17 18 19 . In order to shed some light on the prenatal clinical spectrum of ALVT, we retrospectively reviewed all cases diagnosed prenatally in five large tertiary referral centers for congenital heart defects for the findings of prenatal ultrasound, the intrauterine course, and the postnatal outcome.…”

Section: Introductionmentioning

confidence: 99%

Aorto-Left Ventricular Tunnel – Prenatal Diagnosis and Outcome

et al. 2022

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Purpose Aorto-left ventricular tunnel (ALVT) is an extremely rare, albeit prenatally detectable, extracardiac channel that connects the ascending aorta to the cavity of the left ventricle. Materials and Methods All ALVTs diagnosed prenatally (2006–2020) in five tertiary referral centers were retrospectively assessed for prenatal ultrasound findings, intrauterine course, postnatal outcome, and surgical treatment. We focused on the size of the tunnel and alterations of perfusion of the left ventricular outflow tract and aortic arch. Results 11 fetuses were diagnosed with ALVT at a mean gestational age of 24.8 weeks. All cases were associated with severe dilatation of the left ventricle and a to-and-fro flow in the left outflow tract. Signs of congestive heart failure were present in five fetuses, four of which were terminated and one of which died in the neonatal period. One fetus died in utero at 34 weeks without prior signs of cardiac failure. Of the five survivors, two underwent the Ross procedure. In both cases the prenatal left ventricular outflow was exclusively via a large tunnel. The remaining three neonates underwent patch closure of the tunnel. In these cases, the prenatal outflow of the left ventricle was via the aortic valve and simultaneously over the tunnel. Conclusion Prenatal diagnosis of ALVT should be considered in the presence of left ventricular hypertrophy, dilatation of the aortic root, and to-and-fro flow in the aortic outflow tract. Signs of heart failure are associated with an unfavorable outcome. Large tunnels, particularly in combination with the absence of flow over the aortic valve, may be an unfavorable predictor of surgical repair.

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Section: Introductionmentioning

confidence: 99%

Aorto-Left Ventricular Tunnel – Prenatal Diagnosis and Outcome

et al. 2022

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Central nervous system biometry in fetuses with and without congenital heart diseases

Gutierrez

Schmitz

Hammer

et al. 2022

Arch Gynecol Obstet

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Objective To compare the fetal brain structures assessed in routine sonographic scans during the second and third trimesters in fetuses with and without congenital heart disease (CHD). Methods This is a retrospective cross-sectional single-center study. We measured the head circumference (HC), the transversal diameter of the cerebellum (TCD) and the sizes of the cisterna magna (CM), the cavum septi pellucidi (CSP) and the posterior ventricles (PV) between 20 and 41 weeks of gestation. We compared 160 fetuses with CHD (case group) to 160 fetuses of normal pregnancies (control group). Every patient was matched with a control, considering the gestational age at which the ultrasound was performed. We divided the CHD group into 3 subgroups: retrograde flow in the aortic arch (group 1), right heart anomaly with the antegrade flow in the aortic arch (group 2) and other CHDs with the antegrade flow in the aortic arch (group 3). Results The mean width of the PV was larger in fetuses of groups 1 and 3 in comparison to the control group (P < 0.001, P = 0.022; respectively). We found that the APGAR score at 5 min (P < 0.001, P < 0.001; respectively) and gestational age at delivery (P = 0.006, P = 0.001; respectively) were inferior in groups 1 and 3 compared to controls. Conclusions Central nervous system biometry is altered in fetuses with CHD. PV is enlarged in CHD fetuses especially with decreased oxygen levels in the aortic arch.

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New Aspects in the Diagnosis and Therapy of Fetal Hypoplastic Left Heart Syndrome

Graupner

Enzensberger

Axt-Fliedner

2019

Geburtshilfe Frauenheilkd

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Fetal hypoplastic left heart syndrome (HLHS) is a severe congenital heart disease with a lethal prognosis without postnatal therapeutic intervention or surgery. The aim of this article is to give a brief overview of new findings in the field of prenatal diagnosis and the therapy of HLHS. As cardiac output in HLHS children depends on the right ventricle (RV), prenatal assessment of fetal RV function is of interest to predict poor functional RV status before the RV becomes the systemic ventricle. Prenatal cardiac interventions such as fetal aortic valvuloplasty and non-invasive procedures such as maternal hyperoxygenation seem to be promising treatment options but will need to be evaluated with regard to long-term outcomes. Novel approaches such as stem cell therapy or neuroprotection provide important clues about the complexity of the disease. New aspects in diagnostics and therapy of HLHS show the potential of a targeted prenatal treatment planning. This could be used to optimize parental counseling as well as pre- and postnatal management of affected children.

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Head Biometry in Fetuses with Isolated Congenital Heart Disease

Cited by 3 publications

References 34 publications

Aorto-Left Ventricular Tunnel – Prenatal Diagnosis and Outcome

Aorto-Left Ventricular Tunnel – Prenatal Diagnosis and Outcome

Central nervous system biometry in fetuses with and without congenital heart diseases

New Aspects in the Diagnosis and Therapy of Fetal Hypoplastic Left Heart Syndrome

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