Alterations in cardiac output in fetuses with congenital heart disease.

Journal Article (Journal Article)

OBJECTIVE: Fetuses with severe congenital heart disease (CHD) have altered blood flow patterns. Prior work to assess fetal combined cardiac output (CCO) is limited by sample size and lack of longitudinal gestational data. Our aim was to evaluate CCO in CHD fetuses to determine whether the presence of single ventricle (SV) physiology or aortic obstruction impacts fetal blood flow and cardiovascular hemodynamics. METHOD: Prospective study including singleton fetuses with CHD (n = 141) and controls (n = 118) who underwent a mid- and late-gestation fetal echocardiogram. Ventricular cardiac output was calculated using the standard computation. Combined cardiac output was derived as the sum of the right and left cardiac outputs and indexed to estimated fetal weight. RESULTS: Fetuses with two ventricle (2V) CHD had significantly higher CCO compared to controls and SV CHD fetuses. Fetuses with SV-CHD had similar CCO compared to controls. Fetuses with 2V-CHD and aortic obstruction had significantly higher CCO than fetuses with SV-CHD and aortic obstruction. CONCLUSION: Our findings suggest that the SV can compensate and increase CCO despite the lack of a second functioning ventricle, however, the degree of compensation may be insufficient to support the increased blood flow needed to overcome the hemodynamic and physiologic alternations seen with severe CHD.

Full Text

Duke Authors

Cited Authors

  • Sethi, N; Gai, J; Bost, J; Donofrio, MT

Published Date

  • August 2022

Published In

Volume / Issue

  • 42 / 9

Start / End Page

  • 1133 - 1141

PubMed ID

  • 35698885

Electronic International Standard Serial Number (EISSN)

  • 1097-0223

Digital Object Identifier (DOI)

  • 10.1002/pd.6193

Language

  • eng

Conference Location

  • England