| Cerebral blood flow characteristics and biometry in fetuses undergoing prenatal intervention for aortic stenosis with evolving hypoplastic left heart syndrome. | |
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MedLine Citation:
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PMID: 19931971 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Children with hypoplastic left heart syndrome (HLHS) are at risk for neurodevelopmental dysfunction; prenatal factors may play a role in this predilection. Cerebral blood flow profiles are abnormal in fetuses with HLHS, raising the possibility that cerebral hemodynamics in utero may be related to neurodevelopmental abnormalities. Prenatal aortic valvuloplasty for fetal aortic stenosis with evolving HLHS is technically feasible and improves left heart hemodynamics. This study aimed to assess the effects of prenatal intervention on cerebral blood flow profiles and head circumference in fetuses with evolving HLHS. Seventy fetuses underwent prenatal aortic valvuloplasty for evolving HLHS (median 23 weeks gestation). Among 46 fetuses that had successful valvuloplasty and available data, middle cerebral artery (MCA) pulsatility (PI) and resistive (RI) indices were abnormal (Z-scores -1.7+/-1.1 and -2.2+/-1.4, p<0.001). Early post-valvuloplasty (n=33) and at late gestation follow-up (n=28), MCA PI and RI Z-scores remained low with no difference from pre- or early postintervention. Fetal head circumference was normal, as were umbilical artery PI and RI Z-scores. Cerebral blood flow characteristics are abnormal in mid-gestation fetuses with evolving HLHS, suggesting low cerebral vascular impedance. The mechanisms and significance of these abnormalities are unknown. Prenatal aortic valvuloplasty did not have a major impact on these indices. (E-mail: doff.mcelhinney@cardio.chboston.org). |
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Authors:
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Doff B McElhinney; Carol B Benson; David W Brown; Louise E Wilkins-Haug; Audrey C Marshall; Linda Zaccagnini; Wayne Tworetzky |
Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Ultrasound in medicine & biology Volume: 36 ISSN: 1879-291X ISO Abbreviation: Ultrasound Med Biol Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-12-17 Completed Date: 2010-03-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0410553 Medline TA: Ultrasound Med Biol Country: England |
Other Details:
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Languages: eng Pagination: 29-37 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Children's Hospital Boston, and Pediatrics, Harvard Medical School, Boston, MA, USA. doff.mcelhinney@cardio.chboston.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aortic Valve Stenosis
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complications,
surgery*,
ultrasonography Cerebrovascular Circulation* Female Fetal Heart / physiopathology, surgery*, ultrasonography Head / anatomy & histology Hemodynamics Humans Hypoplastic Left Heart Syndrome / physiopathology, surgery, ultrasonography* Middle Cerebral Artery / physiopathology, ultrasonography Pregnancy Treatment Outcome Ultrasonography, Doppler Ultrasonography, Interventional / methods* Ultrasonography, Prenatal* Umbilical Arteries / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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