Prenatal sonography of the foramen ovale predicts urgent balloon atrial septostomy in neonates with complete transposition of the great arteries

Gatta, Anna Nunzia Della; Contro, E.; Lenzi, Jacopo; Balducci, Anna; Gargiulo, Gaetano; Bodnar, Tetyana; Palleri, Daniela; Bonetti, Simone; Hasan, Tammam; Donti, Andrea; Ragni, Luca; Angeli, Emanuela; Bartolacelli, Ylenia; Larcher, Laura; Pilu, G.; Perolo, A.

doi:10.1016/j.ajogmf.2021.100379

Cited by 10 publications

(15 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They also showed that 3 mm diameter of FO has 80% (CI. 34.1%–96.6%) positive predictive value 4 . In our case, FO diameter was 3 mm and maximal velocity of blood flow through FO was 45 cm/sec, so there was no evident sign of FO restriction.…”

Section: Discussionmentioning

confidence: 47%

See 1 more Smart Citation

Longitudinal functional assessment of atrial M‐mode in dextro‐ transposition of the great arteries fetus may help to predict the necessity for urgent neonatal Rashkind procedure

Respondek‐Liberska

Sylwestrzak

2022

Echocardiography

View full text Add to dashboard Cite

Six fetal echocardiographic examinations were analyzed and presented with special emphasis on atrial M-mode in one case of fetal isolated dextro-transposition of the great arteries. The only significant changes were seen based on analysis of the new index of foramen ovale (FO) flap movement. Emergency Rashkind procedure on the first day of postnatal life was predicted based on fetal atrial M-mode. K E Y W O R D S d-TGA, fetal echocardiography, M-mode How to cite this article: Respondek-Liberska M, Sylwestrzak O. Longitudinal functional assessment of atrial M-mode in dextro-transposition of the great arteries fetus may help to predict the necessity for urgent neonatal Rashkind procedure.

show abstract

Section: Discussionmentioning

confidence: 47%

“…Moreover Della Gatta et al. provided cut‐off value of FO size (>6.5 mm) to predict no need of Rashkind procedure after birth in d‐TGA fetuses, but only eight cases of their group had FO diameter >6.5 mm (17 cases had FO <6.5 mm) 4 . They also showed that 3 mm diameter of FO has 80% (CI.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal functional assessment of atrial M‐mode in dextro‐ transposition of the great arteries fetus may help to predict the necessity for urgent neonatal Rashkind procedure

Respondek‐Liberska

Sylwestrzak

2022

Echocardiography

View full text Add to dashboard Cite

show abstract

“…Similarly, another retrospective study including 60 fetuses affected by dTGA, of which 11 with RFO demonstrated the positive link between FO's dimension and the necessity for urgent BAS, with a measure of <3 mm being associated with a PPV of 80% 19 …”

Section: Results Of the Literature Reviewmentioning

confidence: 86%

“…Unfortunately, the paucity of data did not intercept the cut‐off to define as restrictive the FO contextually with dTGA. Della Gatta et al only mentioned the value of FO diameter <6.5 mm as predictive of urgent intervention at birth with a sensitivity of 100% and specificity of 57.1% and <3 mm with a positive predictive value (PPV) of 80% 19 . Moreover, some studies define FO as restrictive when FO to right atrial diameter ratio is <0.3, FO to interatrial septum length ratio is <0.33 and FO to diameter of ascending aorta ratio is <0.52 10 …”

Section: Results Of the Literature Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Echocardiographic features and outcome of restrictive foramen ovale in fetuses with and without cardiac malformations: Literature review

Vena

Bartolone

D'Alberti

et al. 2022

J of Clinical Ultrasound

View full text Add to dashboard Cite

Foramen ovale is a small communication between the left and the right atrium and its restriction is a rare congenital heart anomaly. There is no consensus on diagnosis and management of fetal restrictive foramen ovale (RFO). In our paper we included 11 studies about fetuses affected by isolated RFO, RFO with D-Transposition of the Great Arteries (dTGA) and RFO with hypoplastic left heart syndrome (HLHS). While fetuses affected from HLHS and dTGA with RFO have a poor prognosis, premature RFO in an otherwise structurally normal heart, if found in later gestation, have an overall good outcome.

show abstract

Role of maternal hyperoxygenation in predicting need for postnatal balloon atrial septostomy in fetal d‐transposition of the great arteries

Szwast,

Penney,

Sharma

et al. 2024

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

ObjectivesPredicting whether balloon atrial septostomy (BAS) will be necessary after birth for fetuses with d‐transposition of the great arteries (d‐TGA) remains challenging. We sought to determine whether measurements obtained during fetal maternal hyperoxygenation (MH) testing can improve our ability to predict need for postnatal BAS.MethodsForty‐one mothers carrying fetuses with d‐TGA with either intact ventricular septum or small ventricular septal defect measuring <3mm underwent MH testing between 33‐38 weeks gestation. Patent foramen ovale (PFO) size, measured by 2D and color Doppler, patent ductus arteriosus (PDA) shunting (all antegrade versus bidirectional) was assessed in room air (RA) and during MH, blinded to postnatal outcome. BAS status and timing were recorded.ResultsPostnatally, 23 neonates underwent BAS while 18 did not, and 14 subjects underwent emergent BAS within 3 hours of life. By univariate analysis, PFO size measured both in RA and MH and all antegrade shunting in the PDA during MH predicted BAS. During MH testing, median PFO size by 2D measured 2.5mm (interquartile range, IQR, 2‐3mm) in fetuses who underwent emergent BAS versus 4.1mm (IQR 3.4‐5mm) in fetuses who did not undergo BAS (p<0.001). By cutpoint analysis, PFO size during MH testing ≤ 3.2mm predicted need for emergent BAS with sensitivity 93% and specificity 78%.ConclusionsIn d‐TGA, measurement of PFO size and direction of PDA shunting during MH testing improves our ability to predict need for BAS postnatally, although additional study is needed. We propose incorporating third trimester MH testing when planning deliveries of d‐TGA fetuses.This article is protected by copyright. All rights reserved.

show abstract

Prenatal sonography of the foramen ovale predicts urgent balloon atrial septostomy in neonates with complete transposition of the great arteries

Cited by 10 publications

References 10 publications

Longitudinal functional assessment of atrial M‐mode in dextro‐ transposition of the great arteries fetus may help to predict the necessity for urgent neonatal Rashkind procedure

Longitudinal functional assessment of atrial M‐mode in dextro‐ transposition of the great arteries fetus may help to predict the necessity for urgent neonatal Rashkind procedure

Echocardiographic features and outcome of restrictive foramen ovale in fetuses with and without cardiac malformations: Literature review

Role of maternal hyperoxygenation in predicting need for postnatal balloon atrial septostomy in fetal d‐transposition of the great arteries

Contact Info

Product

Resources

About