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Pre-intervention morphologic and functional echocardiographic characteristics of neonates with critical left heart obstruction: a Congenital Heart Surgeons Society (CHSS) inception cohort study.

Publication ,  Journal Article
Slieker, MG; Meza, JM; Devlin, PJ; Burch, PT; Karamlou, T; DeCampli, WM; McCrindle, BW; Williams, WG; Morgan, CT; Fleishman, CE; Mertens, L
Published in: European heart journal. Cardiovascular Imaging
June 2019

The aims of this study were to provide a detailed descriptive analysis of pre-intervention morphologic and functional echocardiographic parameters in a large, unselected, multicentre cohort of neonates diagnosed with critical left heart obstruction and to compare echocardiographic features between the different subtypes of left-sided lesions.Pre-intervention echocardiograms for 651 patients from 19 Congenital Heart Surgeons' Society (CHSS) institutions were reviewed in a core lab according to a standardized protocol including >150 morphologic and functional variables. The four most common subtypes of lesions were: aortic atresia (AA)/mitral atresia (MA) (29% of patients), AA/mitral stenosis (MS) (20%), aortic stenosis (AS)/MS (26%), and isolated AS (iAS) (18%). Only 17% of patients with AS/MS had an apex-forming left ventricle, compared with 0% of those with AA/MA and AA/MS (P < 0.0001). Aortic arch hypoplasia and coarctation were common across all four groups, while those with AA/MA and AA/MS had the smallest ascending aorta diameters. Flow in the ascending aorta was retrograde in 43% and 10% of the patients with AS/MS and iAS, respectively. The right ventricle was apex forming in 100% of patients with AA/MA and AA/MS, 96% with AS/MS and 70% with iAS (P < 0.0001). Moderate to severe tricuspid regurgitation was present in 13% of all patients.This large multi-institutional study generates insight into the distribution of the functional and morphologic spectrum in patients with critical left-sided heart disease and identifies differences in these functional and morphologic characteristics between the main anatomic subtypes of critical left heart obstruction.

Published In

European heart journal. Cardiovascular Imaging

DOI

EISSN

2047-2412

ISSN

2047-2404

Publication Date

June 2019

Volume

20

Issue

6

Start / End Page

658 / 667

Related Subject Headings

  • Treatment Outcome
  • Thoracic Surgery
  • Survival Analysis
  • Societies, Medical
  • Severity of Illness Index
  • Retrospective Studies
  • Rare Diseases
  • Prognosis
  • Mitral Valve Stenosis
  • Male
 

Citation

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Slieker, M. G., Meza, J. M., Devlin, P. J., Burch, P. T., Karamlou, T., DeCampli, W. M., … Mertens, L. (2019). Pre-intervention morphologic and functional echocardiographic characteristics of neonates with critical left heart obstruction: a Congenital Heart Surgeons Society (CHSS) inception cohort study. European Heart Journal. Cardiovascular Imaging, 20(6), 658–667. https://doi.org/10.1093/ehjci/jey141
Slieker, Martijn G., James M. Meza, Paul J. Devlin, Phillip T. Burch, Tara Karamlou, William M. DeCampli, Brian W. McCrindle, et al. “Pre-intervention morphologic and functional echocardiographic characteristics of neonates with critical left heart obstruction: a Congenital Heart Surgeons Society (CHSS) inception cohort study.European Heart Journal. Cardiovascular Imaging 20, no. 6 (June 2019): 658–67. https://doi.org/10.1093/ehjci/jey141.
Slieker MG, Meza JM, Devlin PJ, Burch PT, Karamlou T, DeCampli WM, et al. Pre-intervention morphologic and functional echocardiographic characteristics of neonates with critical left heart obstruction: a Congenital Heart Surgeons Society (CHSS) inception cohort study. European heart journal Cardiovascular Imaging. 2019 Jun;20(6):658–67.
Slieker, Martijn G., et al. “Pre-intervention morphologic and functional echocardiographic characteristics of neonates with critical left heart obstruction: a Congenital Heart Surgeons Society (CHSS) inception cohort study.European Heart Journal. Cardiovascular Imaging, vol. 20, no. 6, June 2019, pp. 658–67. Epmc, doi:10.1093/ehjci/jey141.
Slieker MG, Meza JM, Devlin PJ, Burch PT, Karamlou T, DeCampli WM, McCrindle BW, Williams WG, Morgan CT, Fleishman CE, Mertens L. Pre-intervention morphologic and functional echocardiographic characteristics of neonates with critical left heart obstruction: a Congenital Heart Surgeons Society (CHSS) inception cohort study. European heart journal Cardiovascular Imaging. 2019 Jun;20(6):658–667.
Journal cover image

Published In

European heart journal. Cardiovascular Imaging

DOI

EISSN

2047-2412

ISSN

2047-2404

Publication Date

June 2019

Volume

20

Issue

6

Start / End Page

658 / 667

Related Subject Headings

  • Treatment Outcome
  • Thoracic Surgery
  • Survival Analysis
  • Societies, Medical
  • Severity of Illness Index
  • Retrospective Studies
  • Rare Diseases
  • Prognosis
  • Mitral Valve Stenosis
  • Male