Open AccessVentricular Dysfunction in the Case of the Sever Fetal Aortic Stenosis – the Role of Speckle-tracking
Author(s) -
Liliana Gozar,
Daniela Toma,
Amalia Făgărășan,
Dorottya Miklósi,
Rodica Togănel
Publication year - 2020
Publication title -
journal of cardiovascular emergencies
Language(s) - English
Resource type - Journals
eISSN - 2457-5518
pISSN - 2457-550X
DOI - 10.2478/jce-2019-0016
Subject(s) - medicine , cardiology , fetus , stenosis , ejection fraction , aortic valvuloplasty , gestational age , cardiac function curve , gestation , ventricular function , pregnancy , aortic valve stenosis , heart failure , genetics , biology
Congenital aortic stenosis (AS) occurs in around 0.2–0.5% of newborns, and its clinical severity is quite variable. Some of the newborns with AS require urgent medical care: prostaglandin infusion, balloon aortic valvuloplasty, or surgical intervention. Despite having a severe clinical evolution in neonates, the prenatal diagnosis of congenital AS is quite low. We present the case of a fetus with critical AS, who had been prenatally diagnosed at 35 weeks of gestation, via fetal cardiac ultra-sound. The echocardiographic parameters revealed a severely depressed left ventricular systolic function, with dilated chambers, and a severe aortic stenosis. Offline speckle-tracking analysis was performed in order to aid in deciding the optimal methods and timing of delivery. Left ventricular analysis revealed a severely impaired global longitudinal strain of 2.1%, left ventricular ejection fraction 18.4%, increased LV volumes, while the right ventricular function was only mildly depressed. Therefore, the decision was to delay the premature delivery, and the fetus was born at a gestational age of 38 weeks, in a hospital with a neonatal cardiovascular surgery department. The patient had undergone surgical repair of the cardiac anomaly at 3 days after birth.