Prenatal detection of transposition of the great arteries reduces mortality and morbidity

Velzen, C. L. van; Haak, Monique C.; Reijnders, G.; Rijlaarsdam, María; Bax, C.; Pajkrt, Eva; Hruda, J; Galindo-Garré, Francisca; Bilardo, C. M.; Groot, Christianne de; Blom, Nico A.; Clur, S. A.

doi:10.1002/uog.14689

Cited by 86 publications

(87 citation statements)

References 25 publications

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“…Our overall mortality rate was 6.6% which correlates well with recent data ranging between 6.5 and 8.7% [32,33], and considerably lower than the 11-16% reported [34,35]. This rate was very low for simple TGA (1.9%) compared to recent studies showing mortality rates between 3.7 and 12.7% [7,35].…”

Section: Discussionsupporting

confidence: 69%

Transposition of the Great Arteries in Fetal Life: Accuracy of Diagnosis and Short-Term Outcome

Domínguez-Manzano

Mendoza²,

Herraı̀z³

et al. 2016

Fetal Diagn Ther

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Objective: To review our series of prenatally diagnosed transposition of the great arteries (TGA) to analyze the accuracy of fetal echocardiography for achieving a precise diagnosis of the TGA type (simple vs. complex) and to examine the short-term outcome. Methods: A total of 94 cases of simple and complex TGA types (ventriculoarterial discordance with atrioventricular concordance) prenatally evaluated in our referral center between 1998 and 2014 were included. Fetuses with additional congenital anomalies and those with incomplete follow-up were excluded. Prenatal diagnostic accuracy and short-term survival were analyzed for the different types of TGA. Results: The TGA type was correctly ascertained prenatally in 93.3%. Most fetuses were diagnosed with simple TGA (62.7%). There were 6 discrepancies: 5 fetuses with simple TGA had postnatally TGA + ventricular septal defect (VSD; n = 3) or TGA + VSD + coarctation of the aorta (n = 2), and 1 fetus with TGA + VSD postnatally showed severe left ventricular outflow tract obstruction. The mortality rate was 6.6%; it was higher in complex versus simple forms (12.8 vs. 1.9%, p = 0.038), and in cases with intramural coronary artery versus those without (60 vs. 3.5%, p < 0.001). We found no relationship between the arrangement of the great arteries and coronary arterial abnormalities. Conclusions: Simple TGA has a better outcome than the complex forms. A discrepancy rate of 7% with potential influence on the prognosis of survival between the prenatal diagnosis of the TGA type and the definitive diagnosis was found.

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Section: Discussionsupporting

confidence: 69%

Transposition of the Great Arteries in Fetal Life: Accuracy of Diagnosis and Short-Term Outcome

Domínguez-Manzano

Mendoza²,

Herraı̀z³

et al. 2016

Fetal Diagn Ther

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“…In New Zealand, those with antenatally diagnosed critical CHD are delivered at the cardiac centre except in the rare case of unanticipated premature delivery. Improved antenatal detection has been predicted to reduce the risk of adverse outcome including death for d-TGA by 17% in Sweden,26 while in Holland the mortality rate decreased from 6.5% to 0% 27…”

Section: Discussionmentioning

confidence: 99%

Timing of diagnosis affects mortality in critical congenital heart disease

Eckersley

Sadler

Parry³

et al. 2015

Arch Dis Child

126

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“…The lack of prenatal identification of CHD is associated with adverse consequences for the neonate, including abnormal neurological development, and even death. 19–22 In contrast, the prenatal diagnosis of specific cardiac anomalies improves the preoperative condition, 23–27 pre-surgical mortality rate, 28–30 survival after surgery, 19,23,31,32 and long-term neurocognitive function and outcome. 33,34 …”

Section: Introductionmentioning

confidence: 99%

Fetal Intelligent Navigation Echocardiography (FINE) Detects 98% of Congenital Heart Disease

Yeo

Luewan

Romero

2018

J of Ultrasound Medicine

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Objective Fetal Intelligent Navigation Echocardiography (FINE) is a novel method that automatically generates and displays nine standard fetal echocardiography views in normal hearts by applying intelligent navigation technology to spatiotemporal image correlation (STIC) volume datasets. The main objective was to determine the sensitivity and specificity of FINE in the prenatal detection of congenital heart disease (CHD). Methods A case-control study was conducted in 50 fetuses with a broad spectrum of CHD (cases) and 100 fetuses with normal hearts (controls) in the second and third trimesters. Using four-dimensional ultrasound with STIC technology, volume datasets were acquired. After all identifying information was removed, the datasets were randomly distributed to a different investigator for analysis using FINE. The sensitivity and specificity for the prenatal detection of CHD, as well as positive and negative likelihood ratios (LR) were determined. Results The diagnostic performance of FINE for the prenatal detection of CHD was: sensitivity 98% (49/50), specificity 93% (93/100), positive LR of 14, and negative LR of 0.02. Among cases with confirmed CHD, the diagnosis based upon FINE completely matched the final diagnosis in 74% (37/50), minor discrepancies were seen in 12% (6/50), and major discrepancies were seen in 14% (7/50). Conclusions We present for the first time the sensitivity and specificity of the FINE method in fetuses with normal hearts and CHD in the second and third trimesters. Since FINE identifies a broad spectrum of CHD with 98% sensitivity, this method could be used prenatally to screen for and diagnose CHD.

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Prenatal detection of transposition of the great arteries reduces mortality and morbidity

Abstract: Objectives

Cited by 86 publications

References 25 publications

Transposition of the Great Arteries in Fetal Life: Accuracy of Diagnosis and Short-Term Outcome

Transposition of the Great Arteries in Fetal Life: Accuracy of Diagnosis and Short-Term Outcome

Timing of diagnosis affects mortality in critical congenital heart disease

Fetal Intelligent Navigation Echocardiography (FINE) Detects 98% of Congenital Heart Disease

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