Document Detail


Maternal hyperoxygenation and foetal cardiac MRI in the assessment of the borderline left ventricle.
MedLine Citation:
PMID:  25275342     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Using phase-contrast MRI in a foetus with borderline left ventricular hypoplasia at 37 weeks' gestation we showed an increase in pulmonary blood flow during maternal hyperoxygenation. The associated increase in venous return to the left atrium, however, resulted in reversal of the atrial shunt, with no improvement in left ventricular output. The child initially underwent single ventricle palliation with a neonatal hybrid procedure, but following postnatal growth of the left ventricle tolerated conversion to a biventricular circulation at 5 months of age. We conclude that when there is significant restriction of filling or outflow obstruction across the left heart, neither prenatal nor postnatal acute pulmonary vasodilation can augment left ventricular output enough to support a biventricular circulation. Chronic pulmonary vasodilation may stimulate the growth of the left-sided structures allowing biventricular repair, raising the intriguing question of whether chronic maternal oxygen therapy might obviate the need for neonatal single ventricle pallation in the setting of borderline left ventricular hypoplasia.
Authors:
Sharon Borik; Christopher K Macgowan; Mike Seed
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-2
Journal Detail:
Title:  Cardiology in the young     Volume:  -     ISSN:  1467-1107     ISO Abbreviation:  Cardiol Young     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-2     Completed Date:  -     Revised Date:  2014-10-3    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-4     Citation Subset:  -    
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