Pulmonary venous Doppler patterns and midterm outcomes in fetuses with left-sided obstructive lesions and restrictive atrial septum.

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  • Additional Information
    • Affiliation:
      The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati Ohio, USA
    • Abstract:
      Objective: To compare length of stay of the initial neonatal hospitalization and mortality across multiple stages of surgical palliation for infants with left-sided obstructive lesions and severely restrictive or intact atrial septum (I/RAS).Methods: Retrospective cohort study of patients prenatally diagnosed with left-sided obstructive lesions and I/RAS, defined by fetal pulmonary venous Dopplers.Results: We identified 76 fetal patients with 59 live born intending to pursue intervention. Those with I/RAS had longer durations of mechanical ventilation (P = .031) but no difference in intensive care unit or total length of stay. Survival to discharge from neonatal hospitalization was 41.7% in the I/RAS group and 80.7% in the unrestrictive group (P = .001). There was a higher proportion of deaths between stage 1 and stage 2 in the I/RAS group - 5/9 (55.6%) vs 9/50 (18%) in the unrestrictive group (P = .027). Beyond stage 2 palliation there was trend toward a difference in overall mortality (66.7% in I/RAS vs 35.7% in unrestrictive, P = .05) but no statistically significant difference in transplant-free survival (33.3% in I/RAS vs 53.5% in unrestrictive, P = .11).Conclusion: The survival disadvantage conferred by prenatally diagnosed severe atrial septal restriction is most pronounced in the neonatal and early infancy period, with no detectable difference in late midterm transplant-free survival in our cohort.
    • Journal Subset:
      Biomedical; Europe; Peer Reviewed; UK & Ireland
    • ISSN:
      0197-3851
    • MEDLINE Info:
      PMID: NLM32176365 NLM UID: 8106540
    • Publication Date:
      In Process
    • Publication Date:
      20200806
    • DOI:
      10.1002/pd.5682
    • Accession Number:
      144300289
  • Citations
    • ABNT:
      SCHNEIDER, K. et al. Pulmonary venous Doppler patterns and midterm outcomes in fetuses with left-sided obstructive lesions and restrictive atrial septum. Prenatal Diagnosis, [s. l.], v. 40, n. 7, p. 776–784, 2020. DOI 10.1002/pd.5682. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=144300289. Acesso em: 25 set. 2020.
    • AMA:
      Schneider K, Hahn E, Statile C, et al. Pulmonary venous Doppler patterns and midterm outcomes in fetuses with left-sided obstructive lesions and restrictive atrial septum. Prenatal Diagnosis. 2020;40(7):776-784. doi:10.1002/pd.5682
    • APA:
      Schneider, K., Hahn, E., Statile, C., Hirsch, R., Khoury, P. R., Cnota, J., & Divanovic, A. (2020). Pulmonary venous Doppler patterns and midterm outcomes in fetuses with left-sided obstructive lesions and restrictive atrial septum. Prenatal Diagnosis, 40(7), 776–784. https://doi.org/10.1002/pd.5682
    • Chicago/Turabian: Author-Date:
      Schneider, Kristin, Eunice Hahn, Christopher Statile, Russel Hirsch, Philip R. Khoury, James Cnota, and Allison Divanovic. 2020. “Pulmonary Venous Doppler Patterns and Midterm Outcomes in Fetuses with Left-Sided Obstructive Lesions and Restrictive Atrial Septum.” Prenatal Diagnosis 40 (7): 776–84. doi:10.1002/pd.5682.
    • Harvard:
      Schneider, K. et al. (2020) ‘Pulmonary venous Doppler patterns and midterm outcomes in fetuses with left-sided obstructive lesions and restrictive atrial septum’, Prenatal Diagnosis, 40(7), pp. 776–784. doi: 10.1002/pd.5682.
    • Harvard: Australian:
      Schneider, K, Hahn, E, Statile, C, Hirsch, R, Khoury, PR, Cnota, J & Divanovic, A 2020, ‘Pulmonary venous Doppler patterns and midterm outcomes in fetuses with left-sided obstructive lesions and restrictive atrial septum’, Prenatal Diagnosis, vol. 40, no. 7, pp. 776–784, viewed 25 September 2020, .
    • MLA:
      Schneider, Kristin, et al. “Pulmonary Venous Doppler Patterns and Midterm Outcomes in Fetuses with Left-Sided Obstructive Lesions and Restrictive Atrial Septum.” Prenatal Diagnosis, vol. 40, no. 7, June 2020, pp. 776–784. EBSCOhost, doi:10.1002/pd.5682.
    • Chicago/Turabian: Humanities:
      Schneider, Kristin, Eunice Hahn, Christopher Statile, Russel Hirsch, Philip R. Khoury, James Cnota, and Allison Divanovic. “Pulmonary Venous Doppler Patterns and Midterm Outcomes in Fetuses with Left-Sided Obstructive Lesions and Restrictive Atrial Septum.” Prenatal Diagnosis 40, no. 7 (June 2020): 776–84. doi:10.1002/pd.5682.
    • Vancouver/ICMJE:
      Schneider K, Hahn E, Statile C, Hirsch R, Khoury PR, Cnota J, et al. Pulmonary venous Doppler patterns and midterm outcomes in fetuses with left-sided obstructive lesions and restrictive atrial septum. Prenatal Diagnosis [Internet]. 2020 Jun [cited 2020 Sep 25];40(7):776–84. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=144300289