Talk:Cardiovascular System - Hypoplastic Left Heart

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Cite this page: Hill, M.A. (2019, August 23) Embryology Cardiovascular System - Hypoplastic Left Heart. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Cardiovascular_System_-_Hypoplastic_Left_Heart

2019

Arch Dis Child. 2019 Mar 1. pii: archdischild-2018-315887. doi: 10.1136/archdischild-2018-315887. [Epub ahead of print] Congenital left heart obstruction: ethnic variation in incidence and infant survival. Cloete E1, Sadler L2, Bloomfield FH1, Crengle S3, Percival T4, Gentles TL5. Author information Abstract OBJECTIVE: To investigate the relationship between ethnicity and health outcomes among fetuses and infants with congenital left heart obstruction (LHO). DESIGN: A retrospective population-based review was conducted of fetuses and infants with LHO including all terminations, stillbirths and live births from 20 weeks' gestation in New Zealand over a 9-year period. Disease incidence and mortality were analysed by ethnicity and by disease type: hypoplastic left heart syndrome (HLHS), aortic arch obstruction (AAO), and aortic valve and supravalvular anomalies (AVSA). RESULTS: Critical LHO was diagnosed in 243 fetuses and newborns. There were 125 with HLHS, 112 with AAO and 6 with isolated AVSA. The incidence of LHO was significantly higher among Europeans (0.59 per 1000) compared with Māori (0.31 per 1000; p<0.001) and Pacific peoples (0.27 per 1000; p=0.002). Terminations were uncommon among Māori and Pacific peoples. Total case fatality was, however, lower in Europeans compared with other ethnicities (42% vs 63%; p=0.002) due to a higher surgical intervention rate and better infant survival. The perinatal and infant mortality rate was 82% for HLHS, 15% for AAO and 2% for AVSA. CONCLUSION: HLHS carries a high perinatal and infant mortality risk. There are ethnic differences in the incidence of and mortality from congenital LHO with differences in mortality rate suggesting inequities may exist in the perinatal management pathway. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ. KEYWORDS: cardiac disease; congenital anomaly; ethnic disparity; incidence; pregnancy outcomes PMID: 30824490 DOI: 10.1136/archdischild-2018-315887


2016

Are There Head Volume Alterations at 11 to 14 Weeks in Fetuses with Congenital Heart Defects? A First Trimester Case Series

AJP Rep. 2016 Apr;6(2):e232-8. doi: 10.1055/s-0036-1584241.

Abu-Rustum RS1, Ziade MF2, Abu-Rustum SE3, Daou LS4.

Abstract

Objective This study aims to assess head volume (HV) alterations at 11 to 14 weeks in fetuses with congenital heart defects (CHD). Methods A retrospective case-control study on 100 normal and 26 CHD fetuses was conducted. The fetuses had a first trimester scan with volume data sets stored from which HV was calculated. The mean HV and HV as a function of crown-rump length (CRL) in normal fetuses were compared with established normograms. Mean HV, HV as a function of CRL, and HV/CRL were compared between normal and CHD fetuses. Nonparametric Kruskal-Wallis H test was used with p < 0.05 considered significant. Results Overall, 83 normal and 19 CHD fetuses were included. The mean HV and HV as a function of CRL in the normal fetuses were comparable to what has been established (p = 0.451 and 0.801, respectively). The mean HV was statistically smaller in fetuses with CHD, particularly those with hypoplastic left heart (HLH): 10.7 mL in HLH versus 13.0 mL in normal fetuses (p = 0.043). The HV/CRL was statistically smaller in fetuses with CHD (p = 0.01). Conclusion Despite the small sample size, our case series suggests that alterations in HV may potentially be apparent as early as 11 to 14 weeks in CHD fetuses, particularly those with HLH. Larger prospective studies are needed to validate our findings. KEYWORDS: 3D volumetry; first trimester; head volume alterations; heart defects

PMID 27308099