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Fetal cardiac intervention

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https://www.readbyqxmd.com/read/29409551/impact-of-prenatal-diagnosis-on-the-management-and-early-outcome-of-critical-duct-dependent-cardiac-lesions
#1
Varsha Thakur, Nathalie Dutil, Steven M Schwartz, Edgar Jaeggi
OBJECTIVE: The objective of this study was to compare the preoperative management and outcome of neonates with duct-dependent critical CHD with fetal versus postnatal diagnosis. METHODS: Patients referred with CHD to our centre from January 1, 2009 to December 31, 2010 were enrolled prospectively. Live births with a critical form of CHD, a gestational age ⩾36 weeks and a weight ⩾2 kg at birth, and the intention-to-treat were included in this sub-study. Excluded were neonates with lethal non-cardiac and/or genetic anomalies...
February 7, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29398177/percutaneous-fetal-atrial-balloon-septoplasty-for-simple-transposition-of-the-great-arteries-with-an-intact-atrial-septum
#2
Wadi Mawad, Rajiv R Chaturvedi, Greg Ryan, Edgar Jaeggi
We report the first ultrasonographically guided percutaneous balloon atrial septoplasty (BAS), to our knowledge, in a fetus with transposition of the great arteries and an intact ventricular and atrial septum (37 + 2 weeks). After vaginal delivery at 38 weeks, the infant had an elective septostomy (day 1) and an arterial switch procedure (day 7), with an uneventful postoperative course. For centres with experience in fetal cardiac interventions, fetal BAS is a superior management option compared with the alternatives for this high-risk physiology...
December 15, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29377175/the-effect-of-maternal-exposure-to-di-2-ethylhexyl-phthalate-on-fetal-cardiac-development-in-mice
#3
Changqing Tang, Yuxin Deng, Hongyu Duan, Yi Zhang, Yifei Li, Dajian Qiu, Kaiyu Zhou, Yimin Hua, Chuan Wang
Accumulating evidence has suggested a link between maternal di-(2-ethylhexyl)-phthalate (DEHP) exposure and various developmental abnormalities. However, the evidence regarding the effect of maternal DEHP exposure on fetal cardiac development is scarce. The present study aimed to determine the effect of maternal DEHP exposure on fetal cardiac development in mice and explore the possible involved mechanism preliminarily. The C57BL mice were randomly divided into four groups: the vehicle group (corn oil, n = 10), 250 mg kg-1 DEHP group (n = 15), 500 mg kg-1 DEHP group (n = 20) and 1 g kg-1 DEHP group (n = 20)...
January 26, 2018: Journal of Applied Toxicology: JAT
https://www.readbyqxmd.com/read/29375148/comparison-of-four-methods-of-treating-ectopic-pregnancy-a-retrospective-cohort-study
#4
Zeynep Ozturk Inal, Hasan Ali Inal
Objective: To compare the results of expectant management, single and multidose methotrexate (MTX) and surgical management of ectopic pregnancy (EP). Materials and Methods: In this retrospective cohort study, the original files of 233 patients who were treated for EP between May 2009 and December 2016 were analyzed. The patients were assigned to the following groups based on the applied treatment methods: Group 1, expectant management (n = 24), Group 2, single-dose MTX (n = 144), Group 3, multiple-dose MTX (n = 25), and Group 4, surgical intervention (n = 40)...
January 2018: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/29372591/clinical-yield-of-fetal-echocardiography-for-suboptimal-cardiac-visualization-on-obstetric-ultrasound
#5
Rick D Vavolizza, Pe'er Dar, Barrie Suskin, Robert M Moore, Kenan W D Stern
OBJECTIVE: Suboptimal cardiac imaging on obstetric ultrasound is a frequent referral indication for fetal echocardiography, even in the absence of typical risk factors for fetal cardiac disease. The clinical profile of patients and findings of examinations performed for such an indication are not well defined. Given the increased cost, time and resource utilization of fetal echocardiography, we sought to determine the clinical findings of such referrals. STUDY DESIGN: We performed a single-center review of such referrals from January 2010 to June 2016...
January 25, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29317056/a-potentially-curative-fetal-intervention-for-hypoplastic-left-heart-syndrome
#6
Andrew T Hattam
Hypoplastic left heart syndrome (HLHS) encapsulates a spectrum of complex congenital cardiovascular malformations involving varying degrees of underdevelopment of the left-sided heart structures. However, despite improved survival rates since the introduction of staged surgical reconstruction, treatment options for HLHS remain palliative rather than curative. A major limiting factor in the development of definitive curative therapy for HLHS is an incomplete understanding of its pathogenesis. Currently, the aetiology HLHS is best conceptualised by the 'flow theory' of cardiogenesis, which states that normal cardiac development is reliant on the interrelationship of normal flow patterns of blood through the developing heart, and appropriate growth of the cardiac valves and myocardium...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29287139/fetal-interventions-for-structural-heart-disease
#7
David N Schidlow, Lindsay Freud, Kevin Friedman, Wayne Tworetzky
Fetal cardiac intervention (FCI) offers the potential to alter in utero anatomy and physiology. For aortic stenosis with evolving hypoplastic left heart syndrome and pulmonary atresia with intact ventricular septum with evolving hypoplastic right heart syndrome, FCI may result in maintenance of a biventricular circulation, thus avoiding single-ventricle palliation and its attendant complications. In the case of hypoplastic left heart syndrome with intact atrial septum, FCI may ameliorate in utero pathophysiology and portend a more favorable postnatal prognosis...
December 2017: Echocardiography
https://www.readbyqxmd.com/read/29287133/cardiac-function-and-dysfunction-in-the-fetus
#8
Luke Eckersley, Lisa K Hornberger
Evaluation of fetal cardiac function is one of the most important components of fetal echocardiography. Fetal cardiac dysfunction is closely linked to risk of intrauterine fetal demise, in many, but not all cases is indicative of worse postnatal prognosis and may prompt the use of medications or interventions to optimize outcomes. There may be implications for termination versus continuation of pregnancy, an indication for early delivery, a change in location and even mode of delivery. In extreme cases, fetal cardiac dysfunction may prompt prenatal or early neonatal listing for cardiac transplantation...
December 2017: Echocardiography
https://www.readbyqxmd.com/read/29234808/effect-of-levothyroxine-on-miscarriage-among-women-with-normal-thyroid-function-and-thyroid-autoimmunity-undergoing-in-vitro-fertilization-and-embryo-transfer-a-randomized-clinical-trial
#9
RANDOMIZED CONTROLLED TRIAL
Haining Wang, Hongwei Gao, Hongbin Chi, Lin Zeng, Wenhua Xiao, Yanrong Wang, Rong Li, Ping Liu, Chen Wang, Qing Tian, Zehong Zhou, Jin Yang, Ye Liu, Rui Wei, Ben Willem J Mol, Tianpei Hong, Jie Qiao
Importance: Presence of thyroid autoantibodies in women with normal thyroid function is associated with increased risk of miscarriage. Whether levothyroxine treatment improves pregnancy outcomes among women undergoing in vitro fertilization and embryo transfer (IVF-ET) is unknown. Objective: To determine the effect of levothyroxine on miscarriage among women undergoing IVF-ET who had normal thyroid function and tested positive for thyroid autoantibodies. Design, Setting, and Participants: An open-label, randomized clinical trial involving 600 women who tested positive for the antithyroperoxidase antibody and were being treated for infertility at Peking University Third Hospital from September 2012 to March 2017...
December 12, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29216197/shift-toward-greater-pathologic-post-myocardial-infarction-remodeling-with-loss-of-the-adaptive-hypertrophic-signaling-of-alpha1-adrenergic-receptors-in-mice
#10
Che-Chung Yeh, Yanying Fan, Yanchun Xu, Yi-Lin Yang, Paul C Simpson, Michael J Mann
RATIONALE: We have hypothesized that post-infarction cardiac remodeling can be influenced by shifts in the balance between intracellular mediators of "pathologic" and "physiologic" hypertrophy. Although alpha1 adrenergic receptors (alpha1-ARs) mediate pro-adaptive hypertrophy during pressure overload, little is known about their role or downstream mediators after myocardial infarction. METHODS: We performed loss-of-function experiments via coronary ligation in alpha1A-AR knockout (AKO) mice...
2017: PloS One
https://www.readbyqxmd.com/read/29027708/advancing-prenatal-detection-of-congenital-heart-disease-a-novel-screening-protocol-improves-early-diagnosis-of-complex-congenital-heart-disease
#11
Karen M Letourneau, David Horne, Reeni N Soni, Keith R McDonald, Fern C Karlicki, Randy R Fransoo
OBJECTIVES: Prenatal diagnosis of complex congenital heart disease (CHD) during routine obstetric ultrasound (US) examinations improves postnatal outcomes, but sensitivity is low (<40%). Our objective was to improve our prenatal detection of complex CHD with implementation of a specific screening protocol. METHODS: From January 2003 to December 2013, 506 consecutive confirmed cases of complex CHD in the province of Manitoba, Canada, were analyzed to compare the sensitivity and positive predictive value of prenatal US detection of complex CHD before and after the introduction of a novel prenatal screening protocol...
October 13, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28903760/feasibility-of-detecting-myocardial-infarction-in-the-sheep-fetus-using-late-gadolinium-enhancement-cmr-imaging
#12
An Qi Duan, Mitchell C Lock, Sunthara Rajan Perumal, Jack R Darby, Jia Yin Soo, Joseph B Selvanayagam, Christopher K Macgowan, Mike Seed, Janna L Morrison
BACKGROUND: Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging has enabled the accurate assessment of myocardial infarction (MI). However, LGE CMR has not been performed successfully in the fetus, where it could be useful for animal studies of interventions to promote cardiac regeneration. We believe that LGE imaging could allow us to document the presence, extent and effect of MI in utero and would thereby expand our capacity for conducting fetal sheep MI research...
September 13, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28872655/fosterkardiologiska-erfarenheter-fr%C3%A3-n-astrid-lindgrens-barnsjukhus
#13
REVIEW
Felicia Nordenstam, Sven-Erik Sonesson
Fetal Cardiology. Experiences from a tertiary referral centre in Stockholm, Sweden This review provides a brief overview of the current position and clinical experiences of fetal cardiology at a tertiary referral centre in Stockholm, Sweden. In Stockholm, more than 60% of congenital cardiac defects requiring surgery or catheter intervention before one year of age are detected before birth. This not only results in termination of pregnancy in the majority of cases carrying a poor prognosis, but also conveys a better postnatal care and prognosis in cases of continued pregnancy...
August 29, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28867155/the-boundaries-of-fetal-cardiac-intervention-expand-or-tighten
#14
REVIEW
Laura Gellis, Wayne Tworetzky
Fetal cardiac intervention (FCI) is a relatively new and continually evolving field, and, for select cardiac defects, offers the potential to alter the progression of the disease and improve outcomes. It is a procedure that requires a collaborative effort between maternal-fetal medicine, interventional cardiology and fetal echo/ultrasound specialists, as well as fetal and maternal anesthesiologists, nursing specialists, and social workers. This article reviews the most recently reported data and advances in FCI...
December 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28864444/hypoplastic-left-heart-syndrome-with-intact-or-restrictive-atrial-septum-a-report-from-the-international-fetal-cardiac-intervention-registry
#15
LETTER
David W Jantzen, Anita J Moon-Grady, Shaine A Morris, Aimee K Armstrong, Christoph Berg, Joanna Dangel, Carlen G Fifer, Michele Frommelt, Ulrich Gembruch, Ulrike Herberg, Edgar Jaeggi, Eftichia V Kontopoulos, Audrey C Marshall, Owen Miller, Renate Oberhoffer, Dick Oepkes, Carlos A Pedra, Simone R Pedra, Fabio Peralta, Ruben A Quintero, Greg Ryan, Sarah K Gelehrter
No abstract text is available yet for this article.
October 3, 2017: Circulation
https://www.readbyqxmd.com/read/28858090/prenatal-ultrasonic-diagnosis-of-absent-pulmonary-valve-syndrome-a-case-report
#16
Wen-Jun Zhang, Zhong-Lei Zhang, Jun-Jie Chang, Xiao-Yu Song
RATIONALE: Absent pulmonary valve syndrome (APVS) is a rare congenital heart disease that is often associated with tetralogy of Fallot (TOF). Here, we report 2 cases of APVS associated with TOF diagnosed via fetal echocardiography and discuss their specific ultrasonographic characteristics. PATIENT CONCERNS: Two pregnant women with suspicion of fetal heart anomaly were referred from their local hospitals to our hospital for fetal malformation screening and detailed fetal echocardiography...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28837134/clinician-performed-ultrasound-in-fetal-growth-restriction-fetal-neonatal-and-pediatric-aspects
#17
A Sehgal, F Crispi, M R Skilton, W-P de Boode
Fetal growth restriction (FGR) affects 7-10% pregnancies. Conventional and tissue Doppler imaging has noted cardiac compromise during fetal and early neonatal periods in this cohort. In this article, we discuss the use of salient ultrasound parameters across age groups. During fetal life, certain feto-placental sonographic parameters have been linked to adverse perinatal outcomes and are predictive of later life hypertension. During the early postnatal period altered morphometry (hypertrophied and globular hearts) with sub-clinical impairment of cardiac function has been noted in both term and preterm infants with FGR...
August 24, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28828743/pregnancy-in-women-with-congenital-heart-disease
#18
REVIEW
Evin Yucel, Doreen DeFaria Yeh
Advances in cardiac surgical interventions in infancy and childhood have led to an increased number of women with congenital heart disease of childbearing age. For these women, individualized preconception counseling and pregnancy planning should be a vital component of their medical management, and presentation for obstetric care may even be an opportunity to re-establish cardiovascular care for patients who have been lost to follow-up. These patients have unique cardiovascular anatomy and physiology, which is dependent upon the surgical intervention they may have undergone during childhood or adolescence...
August 22, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28796996/call-for-caution-neonatal-portal-vein-thrombosis-following-enbucrilate-embolization-of-placental-chorioangioma
#19
Hian Yan Voon, Rafaie Amin, Juan Loong Kok, Kia Sing Tan
We illustrate a case of giant placental chorioangioma presenting at 20 weeks of gestation. Subsequent monitoring revealed enlargement of the lesion, associated with fetal anemia and cardiac failure, prompting in utero intervention. Amnioreduction followed by percutaneous embolization of the tumour with enbucrilate:Lipiodol Ultra-Fluid™ at a dilution of 1:5 was successfully performed. No repeat intervention or additional supportive measures were required throughout pregnancy and the baby was delivered at 36 weeks of gestation, following spontaneous labour...
August 11, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28780660/update-on-valvular-heart-disease-in-pregnancy
#20
REVIEW
Lucy M Safi, Sarah V Tsiaras
Valvular heart disease in women of childbearing age poses an increased risk of adverse maternal and fetal outcomes, and management in pregnancy can be challenging. Ideally, patients with suspected valvular disease should have preconception counseling by a multidisciplinary team including cardiologists with expertise in pregnancy and a maternal-fetal medicine specialist. Preconception planning should include a cardiac assessment of maternal risk, determination of frequency of surveillance, and a cardiovascular management plan during delivery...
September 2017: Current Treatment Options in Cardiovascular Medicine
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