<i>In‐utero</i> intervention for hypoplastic left heart syndrome — a perinatologist's perspective

Wilkins‐Haug, Louise; Benson, Carol B.; Tworetzky, Wayne; Marshall, Audrey C.; Jennings, Russell W.; Lock, James E.

doi:10.1002/uog.2595

Cited by 35 publications

(24 citation statements)

References 44 publications

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“…In utero surgical interventions for severe aortic stenosis have already shown great promise in improving ventricular function and possibly preventing the development of HLHS [91,111]. Selamet Tierney et al showed that in utero aortic valvuloplasty improves left ventricular systolic function for mid-gestation fetuses that show severe aortic stenosis.…”

Section: Introductionmentioning

confidence: 99%

Fluid Dynamics of Heart Development

Santhanakrishnan

Miller

2011

Cell Biochem Biophys

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The morphology, muscle mechanics, fluid dynamics, conduction properties, and molecular biology of the developing embryonic heart have received much attention in recent years due to the importance of both fluid and elastic forces in shaping the heart as well as the striking relationship between the heart's evolution and development. Although few studies have directly addressed the connection between fluid dynamics and heart development, a number of studies suggest that fluids may play a key role in morphogenic signaling. For example, fluid shear stress may trigger biochemical cascades within the endothelial cells of the developing heart that regulate chamber and valve morphogenesis. Myocardial activity generates forces on the intracardiac blood, creating pressure gradients across the cardiac wall. These pressures may also serve as epigenetic signals. In this article, the fluid dynamics of the early stages of heart development is reviewed. The relevant work in cardiac morphology, muscle mechanics, regulatory networks, and electrophysiology is also reviewed in the context of intracardial fluid dynamics.

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Section: Introductionmentioning

confidence: 99%

Fluid Dynamics of Heart Development

Santhanakrishnan

Miller

2011

Cell Biochem Biophys

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“…Children today that are diagnosed with single ventricle disease undergo the Fontan operation at much earlier time point than my brother, typically 2-4 years of age. Fetal intervention is a possibility for some lesions [36]. With fetal diagnosis, parents and their families are impacted by the transition of a new member into the family and the complexities of a critical health issue that must be addressed early in life [37].…”

Section: Conclusion Changing Population Of Chdmentioning

confidence: 99%

Lifetime Impact of Congenital Heart Disease on a Family from the Perspective of a Third in Birth Order Sibling

2016

J Paediatr Child Care

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Background: Congenital heart disease (CHD) is the number one birth defect reported by the Centers for Disease Control and Prevention [1]. Patients are surviving and thriving into teen and adult years. The evolution of care since the late 1960's for patients and families include routine and unexpected clinic visits, hospitalizations, and procedures. Transitions into acute care systems and subsequent return to chronic care systems are part of the process. This care is required in addition to normal routine health surveillance and illnesses impacting patients, families, resources, and support systems.Recognition of the healthy sibling impact and relationship with chronic health disease is present in the literature with inconsistent results across many diseases. The quality of life literature in CHD is progressing through the years, particularly for patients; however, lifetime healthy sibling impact of CHD continues to be void in the literature. Sibling relationships span the longest time period in a lifetime, typically longer than parents and spouses [2]. Focus on sibling impact of chronic illness is essential to understanding the family dynamics, sibling relationships, roles, and family coping mechanisms when faced with a life-threatening illness like CHD.Method: A Midwestern nuclear intact family is the focus in this case study. In 1968, an infant, second in birth order of 4 siblings, was postnatally diagnosed with complex univentricular CHD requiring repeat surgical and medical follow up throughout his lifetime. This single family review retrospectively spans over four and a half decades from the perspective of third in birth order sibling. Utilizing interviews and personal accounts, a developmental perspective of the impact growing up with an ill sibling throughout childhood and adulthood is reported.Results: Normal developmental milestones of adulthood were achieved by all four siblings including: graduating high school, moving out of the home, marrying, childrearing, and pursuing productive careers. Divorce was not present in the nuclear family and respective adult families. Three of the four siblings graduated with a college degree and a first for our generation.Conclusion: CHD and the acute life threatening issues associated with surgical and medical follow up impacts the family system. Compassion and empathy evolved throughout the lifespan for one sibling. Exposure to emotional, mental, and physical stressors while providing quality health care can be significant. The development of professional compassion fatigue [3] and nursing burnout in the third in birth order sibling was identified.Family resilience was critical to positively moving forward. Eight positive resilience factors were identified as key to maintain a positive focus and live life to the fullest capacity. These included: consistent positive family support, spiritual support, family financial stability, quality health care, strong work ethic, presence of humor, focus on quality of life and normalcy, and drive for adventure and new exp...

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“…Although there are many case reports and case series encountered in the literature of successful fetal cardiac interventions, [3][4][5][6][7][8][9][10][11][12][13][14][15][16] some may consider these procedures still experimental because they are routinely performed in only a few selected centers in the world. Although this is true, data in the literature support our belief that they are reproducible, safe, and effective in different hands, with wellestablished and acceptable outcomes.…”

mentioning

confidence: 99%