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Perinatal course of Ebstein's anomaly and tricuspid valve dysplasia in the fetus
Author(s) -
Lasa Javier J.,
Tian ZhiYun,
Guo Rong,
Rychik Jack
Publication year - 2012
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2939
Subject(s) - medicine , cardiology , tricuspid valve , ebstein's anomaly , fetus , hemodynamics , ejection fraction , fetal echocardiography , dysplasia , hydrops fetalis , heart failure , pregnancy , prenatal diagnosis , biology , genetics
Objective We sought to better define echocardiographic predictors of perinatal mortality in fetuses with Ebstein's anomaly (EA) or tricuspid valve dysplasia (TVD). Method Parameters included measured chamber size, the presence of hydrops, and Doppler recordings of the left ventricular (LV) myocardial performance index (MPI). Results Between 1 January 2000 and 31 December 2008, 21 fetuses were diagnosed with either EA (17) or TVD (4). Five fetuses were lost to follow‐up, and 12 of 16 fetuses were born live (75%). Survivors were found to have smaller right atrial area index scores when compared with non‐survivors (1.025 ± 0312 vs 1.502 ± 0.105, respectively, p = 0.013) and were less likely to present with hydrops (0% survivors vs 75% of non‐survivors, p < 0.01). LV MPI sub‐analysis revealed a shorter combined isovolemic contraction and relaxation time for non‐survivors compared wth survivors (46.5 ± 8.2 ms vs 82.3 ± 21.2 ms, respectively, p = 0.004) although no difference was observed for LV ejection times or overall LV MPI between survivors and non‐survivors. Conclusion Physiologic analysis of left ventricular function via the LV Tei index and its component measurements demonstrates potentially novel insights into hemodynamic derangements and their association with outcomes in patients with EA/TVD. © 2012 John Wiley & Sons, Ltd.