Clinical InvestigationCongenital Heart DiseaseFetal Predictors of Urgent Balloon Atrial Septostomy in Neonates with Complete Transposition
Section snippets
Demographic Data Collection
We collected all fetal and neonatal patients with complete transposition from our reference database using the syngo Dynamics workstation (Siemens Medical Solutions USA, Inc., Ann Arbor, MI). We reviewed all data from January 1, 2001, to June 30, 2010. All newborns with a prenatal diagnosis of complete transposition of the great vessels and postnatal confirmatory echocardiograms were included in the study. Patients with a ventricular septal defect, double outlet right ventricle, or coarctation
Results
Among the 153 patients with complete transposition of the great vessels at our institution from January 1, 2001, to June 30, 2010, 26 (17%) were included in our study with both prenatal and postnatal studies for evaluation (Table 1). Given that our institution is a referral center, not all patients with complete transposition had available fetal studies for evaluation; none of the study patients delivered at the referring hospital. One patient had a persistent left superior vena cava noted
Discussion
In complete transposition of the great vessels, prenatal predictors for an urgent BAS are necessary because tardy management of atrial restriction may result in cerebral hypoxic damage. The results of our study indicate that the hypermobile septum and reverse diastolic ductal shunt represent important risk factors for an urgent BAS. Although there is a brief description of the hypermobile septum, no previous reported study in the literature makes this association.10 Other studies have discussed
Conclusions
Selection of fetuses in need of urgent BAS is necessary to provide optimal care for neonates with complete transposition. The hypermobile interatrial septum and reverse ductal shunt in fetuses with complete transposition are risk factors for urgent BAS postnatally. Taken together with other reported findings, these factors may improve postnatal therapy for neonates with transposition and inadequate circulatory mixing.
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2022, Journal of the American Society of EchocardiographyCitation Excerpt :We did not consider the status of the atrial septum in HLHS or transposition of the great arteries as a factor in accuracy for the purposes of this study. Our focus was predominantly on segmental anatomy, and this has been the subject of other investigations.6,12-15 For cases with major discrepancies (error categories 3 and 4), all original images were blindly reviewed by a senior cardiologist (L.K.H.) to explore whether the diagnosis could have been made on the basis of the available images.
Prenatal sonography of the foramen ovale predicts urgent balloon atrial septostomy in neonates with complete transposition of the great arteries
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Conflicts of Interest: None.