Clinical audit of pre- and postnatal diagnostics of obstructive congenital left heart defects at the perinatal center (level III)
Aim. To compare the data of pre- and postnatal expert echocardiographic diagnostics of obstructive left heart defects (LHD) to identify a possible predictors and reasons for hypo- and overdiagnosis of this.Material and methods. A retrospective analysis of data from expert echocardiography of 194 fet...
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| Fformat: | Erthygl |
| Iaith: | Russian |
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«FIRMA «SILICEA» LLC
2020-09-01
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| Cyfres: | Российский кардиологический журнал |
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| Mynediad Ar-lein: | https://russjcardiol.elpub.ru/jour/article/view/3788 |
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| author | O. V. Shumakova E. L. Bokeria |
| author_facet | O. V. Shumakova E. L. Bokeria |
| author_sort | O. V. Shumakova |
| collection | DOAJ |
| description | Aim. To compare the data of pre- and postnatal expert echocardiographic diagnostics of obstructive left heart defects (LHD) to identify a possible predictors and reasons for hypo- and overdiagnosis of this.Material and methods. A retrospective analysis of data from expert echocardiography of 194 fetuses and newborns with suspected obstructive LHD (coarctation of the aorta (CA), interruption of the aortic arch, aortic stenosis (AS), CA or interruption of the aortic arch with AS, hypoplastic left heart syndrome (HLHS)) was performed.Results. After birth, critical obstructive LHD was confirmed in 59,3% of newborns (115 out of 194): in cases of prenatally diagnosed CA — in 41% of children (42 out of 103); AS — in 67% (4 out of 6); CA with AS — in 65,9% (27 out of 41); HLHS — in 93,9% (39 out of 44); or interruption of the aortic arch with and without AS — in 100% (11 out of 11). After birth, the discrepancy in diagnoses of critical congenital heart defects was detected in 2 cases — obstructive LHD were not confirmed, but total anomalous pulmonary venous drainage (APVD) was detected. In children with a confirmed diagnosis of HLHS after birth, there was a hypodiagnosis of obstructive forms of APVD in three newborns.Conclusion. The probability of confirming a critical obstructive LHD after birth is higher, the more LHD were hypoplasized during intrauterine imaging. APVD may be “hemodynamically masked” as HLHS when prenatal echocardiography is performed. The combination of HLHS and obstructive forms of APVD can lead to HLHS “hemodynamic aggravation” due to an additional decrease in blood flow of left heart. |
| first_indexed | 2024-04-09T20:45:58Z |
| format | Article |
| id | doaj.art-b769902bf762483991b7d9d0feb66960 |
| institution | Directory Open Access Journal |
| issn | 1560-4071 2618-7620 |
| language | Russian |
| last_indexed | 2025-03-14T09:27:19Z |
| publishDate | 2020-09-01 |
| publisher | «FIRMA «SILICEA» LLC |
| record_format | Article |
| series | Российский кардиологический журнал |
| spelling | doaj.art-b769902bf762483991b7d9d0feb669602025-03-02T11:42:51Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202020-09-0125810.15829/1560-4071-2020-37882956Clinical audit of pre- and postnatal diagnostics of obstructive congenital left heart defects at the perinatal center (level III)O. V. Shumakova0E. L. Bokeria1V. I. Kulakova National Medical Research Center for Obstetrics, Gynecology and PerinatologyV. I. Kulakova National Medical Research Center for Obstetrics, Gynecology and Perinatology; I. M. Sechenov First Moscow State Medical UniversityAim. To compare the data of pre- and postnatal expert echocardiographic diagnostics of obstructive left heart defects (LHD) to identify a possible predictors and reasons for hypo- and overdiagnosis of this.Material and methods. A retrospective analysis of data from expert echocardiography of 194 fetuses and newborns with suspected obstructive LHD (coarctation of the aorta (CA), interruption of the aortic arch, aortic stenosis (AS), CA or interruption of the aortic arch with AS, hypoplastic left heart syndrome (HLHS)) was performed.Results. After birth, critical obstructive LHD was confirmed in 59,3% of newborns (115 out of 194): in cases of prenatally diagnosed CA — in 41% of children (42 out of 103); AS — in 67% (4 out of 6); CA with AS — in 65,9% (27 out of 41); HLHS — in 93,9% (39 out of 44); or interruption of the aortic arch with and without AS — in 100% (11 out of 11). After birth, the discrepancy in diagnoses of critical congenital heart defects was detected in 2 cases — obstructive LHD were not confirmed, but total anomalous pulmonary venous drainage (APVD) was detected. In children with a confirmed diagnosis of HLHS after birth, there was a hypodiagnosis of obstructive forms of APVD in three newborns.Conclusion. The probability of confirming a critical obstructive LHD after birth is higher, the more LHD were hypoplasized during intrauterine imaging. APVD may be “hemodynamically masked” as HLHS when prenatal echocardiography is performed. The combination of HLHS and obstructive forms of APVD can lead to HLHS “hemodynamic aggravation” due to an additional decrease in blood flow of left heart.https://russjcardiol.elpub.ru/jour/article/view/3788congenital heart diseasecoarctation of the aortainterruption of aortic archhypoplastic left heart syndromeprenatal diagnosis |
| spellingShingle | O. V. Shumakova E. L. Bokeria Clinical audit of pre- and postnatal diagnostics of obstructive congenital left heart defects at the perinatal center (level III) Российский кардиологический журнал congenital heart disease coarctation of the aorta interruption of aortic arch hypoplastic left heart syndrome prenatal diagnosis |
| title | Clinical audit of pre- and postnatal diagnostics of obstructive congenital left heart defects at the perinatal center (level III) |
| title_full | Clinical audit of pre- and postnatal diagnostics of obstructive congenital left heart defects at the perinatal center (level III) |
| title_fullStr | Clinical audit of pre- and postnatal diagnostics of obstructive congenital left heart defects at the perinatal center (level III) |
| title_full_unstemmed | Clinical audit of pre- and postnatal diagnostics of obstructive congenital left heart defects at the perinatal center (level III) |
| title_short | Clinical audit of pre- and postnatal diagnostics of obstructive congenital left heart defects at the perinatal center (level III) |
| title_sort | clinical audit of pre and postnatal diagnostics of obstructive congenital left heart defects at the perinatal center level iii |
| topic | congenital heart disease coarctation of the aorta interruption of aortic arch hypoplastic left heart syndrome prenatal diagnosis |
| url | https://russjcardiol.elpub.ru/jour/article/view/3788 |
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