Document Detail


Comparison of impact of prenatal versus postnatal diagnosis of congenitally corrected transposition of the great arteries.
MedLine Citation:
PMID:  19840576     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Congenitally corrected transposition of the great arteries (CCTGA) in the absence of major cardiac anomalies is thought to have a good outcome, although this has not been well documented. The objective of the present study was to compare the characteristics and outcomes of patients with a prenatal diagnosis of CCTGA to the characteristics and outcomes of those diagnosed postnatally. The optimal outcome was defined as intervention-free survival. All patients with CCTGA diagnosed prenatally and postnatally from 1999 to 2006 at 2 tertiary care institutions were reviewed. Patients with a single ventricle, heterotaxy, or valvar atresia were excluded. The differences between groups were assessed using the t test and chi-square test. A total of 54 patients (16 prenatal with 14 live born and 39 postnatal) were included. The patients diagnosed prenatally were diagnosed at a median gestational age of 20 weeks (range 16 to 37). Two deaths in each group were due to heart failure. The intervention-free survival rate for the prenatal and postnatal groups at 1, 6, and 36 months was 79%, 45%, and 30% and 85%, 61%, and 23%, respectively (p = NS). Of 37 patients, 14 (38%) underwent an arterial switch plus atrial baffling so that the morphologic left ventricle supported the systemic circulation, and 6 (16%) underwent repair of associated lesions so the morphologic right ventricle supported the systemic circulation; 4 (11%) of the 37 patients had pacemaker only. Prenatal patients with >1 fetal echocardiogram (12 of 14) did not have progression before birth. In conclusion, CCTGA has a >70% risk of intervention in the first 3 years after birth. The outlook is guarded and has an important effect on prenatal counseling.
Authors:
Andrea W Wan; Alexandra Jevremovic; Elif Seda Selamet Tierney; Brian W McCrindle; Elizabeth Dunn; Cedric Manlhiot; Rachel M Wald; John P Kingdom; Edgar T Jaeggi; Lynne E Nield
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-20     Completed Date:  2009-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1276-9     Citation Subset:  AIM; IM    
Affiliation:
Hospital for Sick Children, Labatt Family Heart Centre, University of Toronto, Ontario, Canada. andrea.wan@utoronto.ca
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Surgical Procedures / statistics & numerical data
Child, Preschool
Female
Follow-Up Studies
Humans
Infant
Male
Pacemaker, Artificial / statistics & numerical data
Pregnancy
Prenatal Diagnosis*
Transposition of Great Vessels / diagnosis*,  mortality,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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