Mitral valve dysplasia syndrome: A unique form of left-sided heart disease

Rogers, Lindsay S.; Peterson, Amy L.; Gaynor, J. William; Rome, Jonathan J.; Weinberg, Paul M.; Rychik, Jack

doi:10.1016/j.jtcvs.2011.06.002

Cited by 31 publications

(25 citation statements)

References 15 publications

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“…487,488 Incompetence of the mitral valve is typically attributable to a mitral valve arcade with combined stenosis and insufficiency. Severe mitral regurgitation leads to left atrial dilatation with a restrictive or intact atrial septum.…”

Section: Mitral Valve Dysplasia Syndrome With Mitral Regurgitation Anmentioning

confidence: 99%

“…Fetal cardiac intervention may be considered to open the aortic valve and to promote forward flow 487 ; however, aortic regurgitation after the procedure may complicate the physiology. Opening of the atrial septum with the goal of decompressing the left atrium and improving filling of the right side has also been proposed 488 and may be considered. Left ventricular dysfunction and mitral valve disease may still prevent the use of the left ventricle for a biventricular repair, and a single-ventricle strategy may still be necessary after birth.…”

Section: Mitral Valve Dysplasia Syndrome With Mitral Regurgitation Anmentioning

confidence: 99%

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Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

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973

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: Mitral Valve Dysplasia Syndrome With Mitral Regurgitation Anmentioning

confidence: 99%

Section: Mitral Valve Dysplasia Syndrome With Mitral Regurgitation Anmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

Self Cite

973

543

View full text Add to dashboard Cite

show abstract

“…Critical AS, massive mitral regurgitation (MR), giant left atrium (LA), and fetal hydrops. 17,18 a. These form a unique and challenging subgroup of patients who have been described as such only recently.…”

Section: Relevant Anatomy and Preprocedures Planningmentioning

confidence: 99%

“…17,18 A recent published series showed that this condition is commonly associated with either fetal loss or prematurity and carries a somber prognosis no matter what is performed in the prenatal or postnatal periods. 17 Perhaps in utero ASD creation or enlargement should have been given the same importance as aortic valve dilation.…”

Section: Fetal Cardiac Interventionsmentioning

confidence: 99%

Future Directions of Fetal Interventions in Congenital Heart Disease

Pedra

Peralta

Pedra

2013

Interventional Cardiology Clinics

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“…Der Erfolg der Dilatation lässt sich in der Regel direkt nach dem Eingriff sonografi sch beurteilen, wenn der antegrade Fluss in der aszendierenden Aorta deutlich zunimmt, eine passagere Aortenregurgitation sichtbar wird und sich der zuvor prall dilatierte kaum kontraktile besser kontrahiert und "entspannt" erscheint. beschriebenen abnormalen Blutfl ussgeschwindigkeitsprofi len in den zudem meist an ihren Einmündungen dilatierten Lungenvenen eine Linksherz/Rechtsherz-Flächen-Ratio > 1,5 [ 16 ] sowie das Auftreten eines progredienten Hydrops fetalis [ 49 ] . In letzterer Situation gilt es, den Eingriff als lebensrettende Maß-nahme durchzuführen [ 17 , 50 ] [ 3 ] .…”

Section: Entwicklung Fetaler Katheterinterventionenunclassified

Kardiale Interventionen bei Feten

Gembruch

Geipel

Herberg

et al. 2012

Z Geburtshilfe Neonatol

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Fetal cardiac interventions are being performed with growing success by a minimally invasive percutaneous and transthoracic approach. The primary aim of these interventions is to minimise postnatal morbidity and mortality, rarely also to achieve intrauterine survival. Valvuloplasty in utero for severe aortic stenosis is performed in order to achieve sufficient growth of the left ventricle and to make a later biventricular repair possible. In rare cases with hydrops secondary to massive left ventricular dilatation and mitral insufficiency it is used as a salvage therapy. Premature obstruction of the foramen ovale can be treated by balloon atrioseptoplasty or stenting of the atrial septum with the aim to attain a decompression of the left atrium and consequently of the pulmonary veins. This might reduce the extent of pulmonary hypertension and the resulting vascular and parenchymal changes in affected infants. Intrauterine valvuloplasty of a highly stenotic pulmonary valve or a pulmonary atresia with intact ventricular septum in order to prevent hypoplasia of the right ventricle and to enable postnatal biventricular repair is only rarely justified. Currently these intrauterine cardiac interventions are limited to a small group of fetuses with cardiac defects. However, with enhanced imaging modalities and equipment and with growing experience, fetal cardiac interventions are likely to increase in the next years.

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Mitral valve dysplasia syndrome: A unique form of left-sided heart disease

Cited by 31 publications

References 15 publications

Diagnosis and Treatment of Fetal Cardiac Disease

Diagnosis and Treatment of Fetal Cardiac Disease

Future Directions of Fetal Interventions in Congenital Heart Disease

Kardiale Interventionen bei Feten

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