Late gestation predictors of a postnatal biventricular circulation after fetal aortic valvuloplasty

Objectives Fetal aortic valvuloplasty (FAV) for severe aortic stenosis (AS) has shown promise in averting progression to hypoplastic left heart syndrome. After FAV, predicting which fetuses will achieve a biventricular (BiV) circulation after birth remains challenging. Identifying predictors of post...

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Bibliographic Details
Published in:Prenatal diagnosis 2021-03, Vol.41 (4), p.479-485
Main Authors: Beattie, Meaghan J., Friedman, Kevin G., Sleeper, Lynn A., Lu, Minmin, Drogosz, Monika, Callahan, Ryan, Marshall, Audrey C., Prosnitz, Aaron R., Lafranchi, Terra, Benson, Carol B., Wilkins‐Haug, Louise E., Tworetzky, Wayne
Format: Article
Language:English
Subjects:
Aorta
Aortic arch
Aortic stenosis
Blood circulation
Echocardiography
Fetuses
Gestation
Heart
Hemodynamics
Neonates
Regression analysis
Stenosis
Ventricle
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Summary:Objectives Fetal aortic valvuloplasty (FAV) for severe aortic stenosis (AS) has shown promise in averting progression to hypoplastic left heart syndrome. After FAV, predicting which fetuses will achieve a biventricular (BiV) circulation after birth remains challenging. Identifying predictors of postnatal circulation on late gestation echocardiography will improve parental counseling. Methods Liveborn patients who underwent FAV and had late gestation echocardiography available were included (2000–2017, n = 96). Multivariable logistic regression and classification and regression tree analysis were utilized to identify independent predictors of BiV circulation. Results Among 96 fetuses, 50 (52.1%) had BiV circulation at the time of neonatal discharge. In multivariable analysis, independent predictors of biventricular circulation included left ventricular (LV) long axis z‐score (OR 3.2, 95% CI 1.8–5.7, p 
ISSN:0197-3851
1097-0223
DOI:10.1002/pd.5885