Postnatal Left Ventricular Diastolic Function After Fetal Aortic Valvuloplasty

• Published in: The American journal of cardiology 2011-08, Vol.108 (4), p.556-560
• Main Authors: Friedman, Kevin G., MD, Margossian, Renee, MD, Graham, Dionne A., PhD, Harrild, David M., MD, PhD, Emani, Sitaram M., MD, Wilkins-Haug, Louise E., MD, PhD, McElhinney, Doff B., MD, Tworetzky, Wayne, MD
• Format: Article
• Language: English
• Subjects: Aortic Valve Stenosis; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Case-Control Studies; Catheterization; Coronary vessels; Diastole; Echocardiography, Doppler; Electrocardiography; Female; Humans; Infant; Infant, Newborn; Male; Medical sciences; Pregnancy; Risk Factors; Ultrasonography, Prenatal; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2011.03.085

Fetal aortic balloon valvuloplasty (FAV) has shown promise in altering in utero progression of aortic stenosis to hypoplastic left heart syndrome. In patients who achieve a biventricular circulation after FAV, left ventricular (LV) compliance may be impaired. Echocardiographic indexes of diastolic function were compared between patients with biventricular circulation after FAV, congenital aortic stenosis (AS), and age-matched controls. In the neonatal period, patients with FAV had similar LV, aortic, and mitral valve dimensions but more evidence of endocardial fibroelastosis than patients with AS. Patients with FAV underwent more postnatal cardiac interventions than patients with AS (p = 0.007). Mitral annular early diastolic tissue velocity (E′) was lower in patients with FAV and those with AS and controls in the neonatal period and over follow-up (p