Journal article

Hypoplastic left heart syndrome with prenatally diagnosed foramen ovale restriction: diagnosis, management and outcome


Authors listJadczak, Anna; Respondek-Liberska, Maria; Sokolowski, Lukasz; Chrzanowski, Jedrzej; Rizzo, Giuseppe; Araujo Junior, Edward; Bravo-Valenzuela, Nathalie Jeanne; Axt-Fliedner, Roland; Slodki, Maciej

Publication year2022

Pages291-298

JournalThe Journal of Maternal-Fetal & Neonatal Medicine

Volume number35

Issue number2

ISSN1476-7058

eISSN1476-4954

DOI Linkhttps://doi.org/10.1080/14767058.2020.1716717

PublisherTaylor and Francis Group


Abstract
Objective: Despite advances in prenatal diagnosis and postnatal intervention/surgery methods, patients with Hypoplastic Left Heart Syndrome (HLHS) and coexisting foramen oval restriction still achieve high mortality rates. Our objective was to determine survival predictors and to find answers to, why restriction develops in some, but not others. Methods: We performed a retrospective analysis of prenatal history and postnatal sequel of 22 patients with HLHS and foramen ovale restriction between 2008 and 2017. Results: There were 11 survivors and 11 nonsurvivors. The most significant difference between the two groups pertained to the average time of foramen ovale restriction diagnosis which was 33 weeks for survivors and 28 weeks for nonsurvivors (p = .0416) and the duration of in-utero restriction (9 versus 5 weeks, p = .0213). Twenty patients (20/22) exhibited possible signs of infection. Conclusions: (1) Earlier development and longer presence of foramen ovale restriction in the setting of HLHS is associated with higher short-term mortality regardless of the degree of restriction. (2) Ratio of forward pulmonary vein flow to reverse flow (f/r) expressed as a velocity-time integral (VTI) is a good emergent intervention predictor, but it does not correlate with foramen ovale size and maximal velocity, nor does it influence survival rates. (3) Ultrasonographic signs of possible infection of the fetus is a potential risk factor of foramen ovale restriction development in patients with HLHS.



Citation Styles

Harvard Citation styleJadczak, A., Respondek-Liberska, M., Sokolowski, L., Chrzanowski, J., Rizzo, G., Araujo Junior, E., et al. (2022) Hypoplastic left heart syndrome with prenatally diagnosed foramen ovale restriction: diagnosis, management and outcome, The Journal of Maternal-Fetal & Neonatal Medicine, 35(2), pp. 291-298. https://doi.org/10.1080/14767058.2020.1716717

APA Citation styleJadczak, A., Respondek-Liberska, M., Sokolowski, L., Chrzanowski, J., Rizzo, G., Araujo Junior, E., Bravo-Valenzuela, N., Axt-Fliedner, R., & Slodki, M. (2022). Hypoplastic left heart syndrome with prenatally diagnosed foramen ovale restriction: diagnosis, management and outcome. The Journal of Maternal-Fetal & Neonatal Medicine. 35(2), 291-298. https://doi.org/10.1080/14767058.2020.1716717



Keywords


ATRIAL SEPTUMCAREECHOCARDIOGRAPHYFETUSESHypoplastic left heart syndromeINTACTOBSTRUCTIONperinatal outcomeprenatal diagnosisPULMONARY VENOUS FLOWrestriction of the foramen ovale

Last updated on 2025-21-05 at 18:24