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Fetal cardiac intervention

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https://www.readbyqxmd.com/read/29652283/mitral-valve-repair-in-infective-endocarditis-during-pregnancy
#1
Takahiro Tamura, Shuichi Yokota
Infective endocarditis (IE) during pregnancy and subsequent cardiac surgery are rare and associated with a high risk of mortality for the mother and fetus. It is difficult to determine the right time for cardiac intervention when IE is diagnosed early in pregnancy. A 33-year-old previously healthy woman in the 11th week of pregnancy was diagnosed with IE and underwent surgical intervention. The cardiopulmonary bypass settings and the anesthetic drugs were carefully chosen. Although she was in good health, while being discharged, the fetus did not survive...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29579059/cardiac-findings-in-infants-with-in-utero-exposure-to-zika-virus-a-cross-sectional-study
#2
Dulce H G Orofino, Sonia R L Passos, Raquel V C de Oliveira, Carla Verona B de Farias, Maria de Fatima M P Leite, Sheila M Pone, Marcos V da S Pone, Helena A R Teixeira Mendes, Maria Elizabeth L Moreira, Karin Nielsen-Saines
BACKGROUND: Antenatal exposure to Zika virus (ZIKV) is related to severe neurological manifestations. A previous study in Brazil reported an increased incidence of non-severe congenital heart defects in infants with diagnosis of congenital Zika syndrome but without laboratory confirmation of ZIKV infection in the mother or infant. The objective of this study is to report echocardiographic (ECHO) findings in infants with laboratory confirmed antenatal exposure to ZIKV. METHODOLOGY: Cross sectional study of cardiologic assessments of infants born between November 2015 and January 2017 with confirmed vertical exposure to ZIKV in Rio de Janeiro, Brazil...
March 26, 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29577782/anatomically-corrected-malposition-of-the-great-arteries-a-challenging-fetal-diagnosis
#3
Nathalie Jeanne Bravo-Valenzuela, Milene Carvalho Carrilho, Alberto Borges Peixoto, Marilim Souza Bezerra, Edward Araujo Júnior
Anatomically corrected malposed great arteries is an uncommon and benign entity. Basically, this occurs with ventriculoarterial concordance in which the great vessels arise parallel instead of a twisting fashion. In this manuscript, we described two cases in which the antenatal diagnosis of anatomically corrected malposition of great arteries was suspected and confirmed during the postnatal period. During the fetal life, this diagnosis remains a challenge and this condition is often misdiagnosed as the transposition of the great arteries (TGA)...
March 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29561649/magnesium-sulfate-and-sex-differences-in-cardiovascular-and-neural-adaptations-during-normoxia-and-asphyxia-in-preterm-fetal-sheep
#4
Robert Galinsky, Simerdeep K Dhillon, Christopher A Lear, Kyohei Yamaguchi, Guido Wassink, Alistair J Gunn, Laura Bennet
Magnesium sulfate (MgSO4 ) is recommended for preterm neuroprotection, preeclampsia and preterm labor prophylaxis. There is an important unmet need to carefully test clinical interventions in both sexes. Therefore, we aimed to investigate cardiovascular and neurophysiological adaptations to MgSO4 during normoxia and asphyxia in preterm male and female fetal sheep. Fetuses were instrumented at 98{plus minus}1 days of gestation (d; term=147 d). At 104 d, unanaesthetised fetuses were randomly assigned to intravenous MgSO4 (n=12 F, 10 M) or saline (n=13 F, 10 M)...
March 21, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29409551/impact-of-prenatal-diagnosis-on-the-management-and-early-outcome-of-critical-duct-dependent-cardiac-lesions
#5
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
#6
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...
March 2018: 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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)
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