PMID: 1960988Dec 1, 1991

Diagnosis, transport, and outcome in fetuses with left ventricular outflow tract obstruction

The Journal of Thoracic and Cardiovascular Surgery
A C ChangW I Norwood

Abstract

Between March 1986 and April 1990, 22 consecutive fetuses (at gestational ages of 21 to 38 weeks) with a suspected diagnosis of critical (ductus-dependent) left ventricular outflow tract obstruction on fetal echocardiogram were referred to our center for delivery and surgical treatment. Diagnoses were hypoplastic left heart syndrome (n = 16), valvular aortic stenosis (n = 2), common atrioventricular canal with subaortic stenosis (n = 3), and single ventricle with subaortic stenosis (n = 1). Postnatal echocardiography revealed that fetal echocardiography was correct in predicting left ventricular outflow tract obstruction to be critical in all but one patient, for a positive predictive value of 96%. Of the 21 patients with true, critical left ventricular outflow tract obstruction, 17 patients underwent cardiac surgery as neonates (birth to 6 days of age, median 2 days); 13 (or 77%) survived and were discharged from the hospital. In addition, one patient underwent successful balloon aortic valvotomy for critical valvular aortic stenosis but later died of sepsis. Lethal chromosomal and congenital abnormalities should be sought and are contraindications for this approach. In utero transport of fetuses with suspected critical left v...Continue Reading

References

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Jul 15, 1997·The American Journal of Cardiology·J H KernJ M Quaegebeur
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Jul 2, 2008·Obstetrics and Gynecology·Uma M ReddyPregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Departme
Mar 4, 2000·Heart·L D Allan
Jul 9, 2004·Cardiology in the Young·Robin R Fountain-DommerGirish S Shirali

Related Concepts

Septicemia
Uterus
Discipline of Heart Surgery
Myopathy
Atrioventricular CANAL Defect
Aortic Valve Stenosis
Echocardiography
Common Atrioventricular Canal
Fetal Ultrasonography
Aorta

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