A5037778344- Congenital Heart Disease Studies
- Cardiovascular Issues in Pregnancy
- Cardiac Valve Diseases and Treatments
- Congenital Diaphragmatic Hernia Studies
- Aortic Disease and Treatment Approaches
- Cardiac Structural Anomalies and Repair
- Tracheal and airway disorders
- Cardiac Arrhythmias and Treatments
- Congenital heart defects research
- Coronary Artery Anomalies
- Cardiovascular Function and Risk Factors
- Cardiovascular and Diving-Related Complications
- Neonatal Respiratory Health Research
- Fetal and Pediatric Neurological Disorders
- Mechanical Circulatory Support Devices
- Neonatal and fetal brain pathology
- Pulmonary Hypertension Research and Treatments
- Vascular anomalies and interventions
- Congenital Anomalies and Fetal Surgery
- Prenatal Screening and Diagnostics
- Pregnancy and preeclampsia studies
- Cardiovascular Conditions and Treatments
- Systemic Lupus Erythematosus Research
- Vascular Malformations Diagnosis and Treatment
- Renal and Vascular Pathologies
Boston Children's Hospital
2015-2024
Harvard University
2015-2024
Boston Children's Museum
2009-2024
Brigham and Women's Hospital
2004-2022
John Wiley & Sons (United Kingdom)
2018
Hudson Institute
2018
Boston University
2008-2015
University of Utah
2015
Primary Children's Hospital
2015
Harvard University Press
2011-2013
Background —Hypoplastic left heart syndrome (HLHS) is frequently diagnosed prenatally, but this has not been shown to improve surgical outcome. Methods and Results —We reviewed patients with HLHS between July 1992 March 1999 determine the influence of prenatal diagnosis on preoperative clinical status, outcomes stage 1 surgery, parental decisions regarding care. Of 88 patients, 33 were prenatally 55 after birth. 22 live-born, pregnancy was terminated in 11. who 14 underwent parents elected...
Adverse neurodevelopmental outcome is an important source of morbidity in children with congenital heart disease (CHD). A significant proportion newborns complex CHD have abnormalities brain size, structure, or function, which suggests that antenatal factors may contribute to childhood morbidity.Brain volume and metabolism were compared prospectively between 55 fetuses 50 normal the use 3-dimensinal volumetric magnetic resonance imaging proton spectroscopy. Fetal intracranial cavity volume,...
Preventing the progression of fetal aortic stenosis (AS) to hypoplastic left heart syndrome (HLHS) requires identification fetuses with salvageable hearts who would progress HLHS if untreated, a successful in utero valvotomy, and demonstration that valvotomy promotes growth utero. Fetuses meeting first criterion are undefined, previous reports AS dilation have not evaluated impact intervention on structures.We offered 24 mothers whose had AS. At least 3 echocardiographers assigned high...
Background— Fetal aortic valvuloplasty may prevent progression of stenosis (AS) to hypoplastic left heart syndrome (HLHS). Predicting which fetuses with AS will develop HLHS is essential optimize patient selection for fetal intervention. The aim this study was define echocardiographic features associated midgestation HLHS. Methods and Results— echocardiograms were reviewed from 43 diagnosed normal ventricular (LV) length at ≤30 weeks’ gestation. Of 23 live-born patients available follow-up...
Aortic stenosis in the midgestation fetus with a normal-sized or dilated left ventricle predictably progresses to hypoplastic heart syndrome when associated certain physiological findings. Prenatal balloon aortic valvuloplasty may improve growth and function, possibly preventing evolution syndrome.Between March 2000 October 2008, 70 fetuses underwent attempted for critical evolving syndrome. We analyzed this experience determine factors procedural postnatal outcome. The median gestational...
Neurologic impairment is a major complication of complex congenital heart disease (CHD). A growing body evidence suggests that neurologic dysfunction may be present in significant proportion this high-risk population the early newborn period prior to surgical interventions. We recently provided first brain growth fetuses with CHD has its origins utero. Here, we extend these observations by characterizing global and regional development hypoplastic left syndrome (HLHS), one most severe forms...
Fetal aortic valvuloplasty can be performed for severe midgestation stenosis in an attempt to prevent progression hypoplastic left heart syndrome (HLHS). A subset of patients has achieved a biventricular (BV) circulation after fetal valvuloplasty. The postnatal outcomes and survival the BV patients, comparison with those managed as HLHS, have not been reported.We included 100 who underwent evolving HLHS from March 2000 January 2013. Patients were categorized based on management or HLHS....
Neurodevelopmental impairment is common in children with congenital heart disease (CHD), but postnatal variables explain only 30% of the variance outcomes. To explore whether antecedents for neurodevelopmental disabilities might begin utero, we analyzed fetal brain volume predicted subsequent outcome CHD.
Infants born with hypoplastic left heart syndrome and an intact or highly restrictive atrial septum face a neonatal mortality of at least 48% despite early postnatal decompression palliative surgery. Prenatal has been suggested as means improving these outcomes. This study reports the feasibility fetal catheterization to create interatrial communication describes technical considerations.Seven fetuses 26 34 weeks' gestation underwent attempted prenatal intervention. Under ultrasound...
Ebstein anomaly and tricuspid valve dysplasia are rare congenital malformations associated with high perinatal mortality. The literature consists of small, single-center case series spanning several decades. We performed a multicenter study to assess the outcomes factors mortality after fetal diagnosis in current era.Fetuses diagnosed from 2005 2011 were included 23 centers. primary outcome was mortality, defined as demise or death before neonatal discharge. Of 243 fetuses at mean...
Neonates with hypoplastic left heart syndrome and intact or highly restrictive atrial septum have a high rate of mortality. We sought to assess the effect prenatal intervention intended create septal defects in fetuses this diagnosis.We reviewed medical records imaging all undergoing for defect creation setting septum. The procedures were performed percutaneous cardiac puncture under guidance ultrasonography. For 21 interventions, patient procedural characteristics analyzed identify...
Prenatal intervention for fetuses with pulmonary atresia an intact ventricular septum (PA/IVS) has the potential to alter right heart physiologic features in utero, facilitating growth and improving prospect of a biventricular outcome after birth.Since 2002, we have considered prenatal fetal PA/IVS patients (1) membranous atresia, identifiable valve (PV) leaflets or membrane; (2) highly restrictive septum; (3) hypoplasia, tricuspid annulus z score -2 below but small ventricle. Intervention...
ABSTRACT Objectives Fetal aortic valvuloplasty (FAV) may prevent progression of mid‐gestation stenosis to hypoplastic left heart syndrome (HLHS). The aim this study was evaluate whether technical success and biventricular (Biv) outcome after FAV have changed from an earlier (2000–2008) a more recent (2009–2015) era identify pre‐FAV predictors Biv outcome. Methods We evaluated procedural postnatal outcomes in 123 fetuses that underwent for evolving HLHS at Boston Children's Hospital between...
Prenatal detection (PND) has benefits for infants with hypoplastic left heart syndrome (HLHS) and transposition of the great arteries (TGA), but associations between sociodemographic geographic factors PND have not been sufficiently explored. This study evaluated whether socioeconomic quartile (SEQ), public insurance, race ethnicity, rural residence, distance residence (distance driving time from a cardiac surgical center) are associated or timing PND, secondary aim to analyze differences...
Congenital heart disease (CHD) is associated with abnormal brain development in utero. We applied innovative fetal magnetic resonance imaging (MRI) techniques to determine whether reduced cerebral substrate delivery impacts the globally, or a region-specific pattern. Our novel design included two control groups, one and other without family history of CHD, explore contribution shared genes and/or environment development.From 2014 2018, we enrolled 179 pregnant women into 4 groups: "HLHS/TGA"...
OBJECTIVE. Pulmonary atresia with intact ventricular septum is a complex congenital cardiovascular anomaly that frequently requires single ventricle palliation. Fetal diagnosis of pulmonary common, but the natural history diagnosed in midgestation, predictors neonatal anatomy, and biventricular repair have not been determined. The objective this study was to determine whether size rate growth fetal tricuspid valve predict anatomy repair. DESIGN AND RESULTS. Twenty-three fetuses between 1990...