Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-10T05:42:18.519Z Has data issue: false hasContentIssue false
  • English
  • Français

Does a prenatal diagnosis affect mortality and morbidity for neonatal arterial switch operation

Published online by Cambridge University Press:  06 January 2022

Osman Guvenc Open the ORCID record for Osman Guvenc [Opens in a new window] ,
Serdar Beken ,
Aysegul Inamlik ,
Eda Albayrak ,
Bahar Temur Open the ORCID record for Bahar Temur [Opens in a new window] ,
Serdar Basgoze ,
Selim Aydin ,
Murat Saygi ,
Ender Ödemiş  and
Ersin Erek
...Show all authors
Osman Guvenc*
Affiliation:
Department of Pediatric Cardiology, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Serdar Beken
Affiliation:
Department of Neonatology, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Aysegul Inamlik
Affiliation:
Department of Pediatrics, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Eda Albayrak
Affiliation:
Department of Pediatrics, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Bahar Temur
Affiliation:
Department of Cardiovascular Surgery, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Serdar Basgoze
Affiliation:
Department of Cardiovascular Surgery, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Selim Aydin
Affiliation:
Department of Cardiovascular Surgery, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Murat Saygi
Affiliation:
Department of Pediatric Cardiology, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Ender Ödemiş
Affiliation:
Department of Pediatric Cardiology, Koc University Medical Faculty, Istanbul, Turkey
Ersin Erek
Affiliation:
Department of Cardiovascular Surgery, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
Ayse Korkmaz Toygar
Affiliation:
Department of Neonatology, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey
*
Author for correspondence: O. Guvenc, Department of Pediatric Cardiology, Acibadem Universitesi Tip Fakultesi, Istanbul, Turkey. E-mail: osmanguvenc1977@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

The effect of prenatal diagnosis on prognosis in patients with transposition of the great arteries is not clear. In this study, we compared the outcomes after arterial switch operation.

Methods:

Outcome of 112 patients who had arterial switch operation in the neonatal period were analysed. The patients were divided into two groups: those who had prenatal diagnosis (Group 1; n = 34) and those who did not (Group 2; n = 78). The patients were also classified based on their diagnosis: simple transposition, transposition with ventricular septal defect and/or aortic arch hypoplasia, and Taussig–Bing anomaly.

Results:

In Group 1, the C-section delivery rate was higher (82% vs. 44%; p = 0.004), and it was observed that patients in Group 1 were more often intubated upon admission to the neonatal ICU (38% vs. 9%; p = 0.005). No differences were found between the two groups in terms of operation time, cardiopulmonary bypass time, post-operative invasive respiratory support duration, or extracorporeal membrane oxygenation support. It was observed that those who had Taussig–Bing anomaly had a higher mortality.

Conclusions:

Timely treatment have a positive effect on neonatal mortality and morbidity. That’s why all families with prenatal diagnosis of critical CHD should be recommended to have the delivery in a tertiary care hospital. Although it could not be demonstrated in this study, prenatal diagnosis has a potential to improve surgical results especially in countries or cities, which does not have enough resources for transfer and surgical units. Further efforts are needed to improve prenatal screening programmes.

Keywords

Arterial switch operationprenatal diagnosistransposition of great arteriesTaussig–Bing anomalynewborn
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 10 , October 2022 , pp. 1644 - 1648
Check for updates
Copyright
© The Author(s), 2022. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Qureshi, AM, Justino, H, Heinle, JS. Transposition of the great arteries. In: Shaddy, RE, Penny, DJ, Feltes, TF, Cetta, F, Mital, S (eds). Moss and Adams Heart Disease in Infants, Children and Adolescents Including the Fetus and Young Adult, 10th edn. Wolters Kluwer, Philadelphia, 2022: 3695–3760.Google Scholar
Turon Vinas, A, Veciana, AR, Moreno Harnendo, J, et al. Characteristics and outcomes of transposition of great arteries in the neonatal period. Rev Esp Cardiol 2014; 67: 114–119.Google ScholarPubMed
Reddy, CD, Silverman, NH, Wright, GE, Maeda, K, Hanley, FL, Roth, SJ. Double Outlet Right Ventricle. In: Shaddy, RE, Penny, DJ, Feltes, TF, Cetta, F, Mital, S (eds). Moss and Adams Heart Disease in Infants, Children and Adolescents Including the Fetus and Young Adult, 10th edn. Wolters Kluwer, Philadelphia, 2022: 3815–3866.Google Scholar
Erek, E, Suzan, D, Aydın, S, et al. Outcomes of arterial switch operation for Taussig-Bing anomaly versus transposition of great arteries and ventricular septal defect. Turk Gogus Kalp Damar 2019; 27: 266–273.CrossRefGoogle ScholarPubMed
van Velzen, CL, Haak, MC, Reijnders, G, et al. Prenatal detection of transposition of the great arteries reduces mortality and morbidity. Ultrasound Obstet Gynecol 2015; 45: 320–325.CrossRefGoogle ScholarPubMed
Lara, DA, Fixler, DE, Ethen, MK, Canfield, MA, Nembhard, WN, Morris, SA. Prenatal diagnosis, hospital characteristics, and mortality in transposition of the great arteries. Birth Defects Res A Clin Mol Teratol 2016; 106: 739–748.CrossRefGoogle ScholarPubMed
Jaggers, JJ, Cameron, DE, Herlong, JR, Ungerleider, RM. Congenital Heart Surgery Nomenclature and Database Project: transposition of the great arteries. Ann Thorac Surg 2000; 69: 205–235.CrossRefGoogle ScholarPubMed
Byrne, ML, Glatz, AC, Griffis, Song L, Millenson, HM, Gillespie, ME, et al. Association between variation in preoperative care before arterial switch operation and outcomes in patients with transposition of the great arteries. Circulation 2018; 138: 2119–2129.Google Scholar
Blyth, M, Howe, D, Gnanapragasam, J, Wellesley, D. The hidden mortality of transposition of the great arteries and survival advantage provided by prenatal diagnosis. BJOG 2008; 115: 1096–1100.CrossRefGoogle ScholarPubMed
Cloete, E, Bloomfield, FH, Sadler, L, et al. Antenatal detection of treatable critical congenital heart disease is associated with lower morbidity and mortality. J Pediatr 2019; 204: 66–70.CrossRefGoogle ScholarPubMed
Li, YF, Zhou, KY, Fang, J, Wang, C, Hua, YM, Mu, DZ. Efficacy of prenatal diagnosis of major congenital heart disease on perinatal management and perioperative mortality: a meta-analysis. World J Pediatr 2016; 12: 298–307.CrossRefGoogle ScholarPubMed
Holland, BJ, Myers, JA, Woods, JR. Prenatal diagnosis of critical congenital heart disease reduces risk of death from cardiovascular compromise prior to planned neonatal cardiac surgery: a meta-analysis. Ultrasound Obstet Gynecol 2015; 45: 631–638.CrossRefGoogle ScholarPubMed
Bekmez, BO, Alyamaç Dizdar, E, Okur, N, Büyüktiryaki, M, Uras, N, Oğuz, SS. Does prenatal diagnosis of critical congenital heart diseases influence the prereferral mortality in a center without surgical intervention? J Matern Fetal Neonatal Med 2018; 32: 3431–3434. DOI 10.1080/14767058.2018.1465551.CrossRefGoogle Scholar
Bonnet, D, Coltri, A, Butera, G, et al. Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality. Circulation 1999; 99: 916–918.CrossRefGoogle ScholarPubMed
Landis, B, Levey, A, Levasseur, SM, et al. Prenatal diagnosis of congenital heart disease and birth outcomes. Pediatr Cardiol 2013; 34: 597–605.CrossRefGoogle ScholarPubMed
Gupta, D, Mowitz, ME, Lopez Colon, D, Nixon, CS, Vyas, HV, Co-Vu, JG. Effect of prenatal diognosis on hospital costs in complete transposition of the great arteries. Prenat Diagn 2018; 38: 567–571.CrossRefGoogle Scholar