Abstract 15904: Extracardiac Doppler Abnormalities Are Associated With Perinatal Mortality in Fetuses With Ebstein Anomaly and Tricuspid Valve Dysplasia

IntroductionEbstein anomaly and tricuspid valve dysplasia (EA/TVD) are congenital malformations associated with high perinatal mortality. In a recent multi-center study of fetuses with EA/TVD, we found that early gestational age (GA) at diagnosis, large tricuspid valve (TV) annulus Z-score, presence...

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Published in:Circulation (New York, N.Y.) N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A15904-A15904
Main Authors: Wang, Shuo, Freud, Lindsay R, Detterich, Jon A, Moon-Grady, Anita J, Donofrio, Mary T, Jaeggi, Edgar T, Szwast, Anita L, Morris, Shaine A, Kavanaugh-McHugh, Ann, Howley, Lisa W, van der Velde, Mary E, Cuneo, Bettina F, Phoon, Colin K, Tworetzky, Wayne, Pruetz, Jay D
Format: Article
Language:English
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Summary:IntroductionEbstein anomaly and tricuspid valve dysplasia (EA/TVD) are congenital malformations associated with high perinatal mortality. In a recent multi-center study of fetuses with EA/TVD, we found that early gestational age (GA) at diagnosis, large tricuspid valve (TV) annulus Z-score, presence of pulmonary regurgitation (PR), and pericardial effusion predicted mortality. We sought to describe the extracardiac Doppler indices in this cohort and to assess their additive value in predicting mortality.MethodsFetuses with EA/TVD from 23 centers between 2005 and 2011 were included for this retrospective study. Extracardiac Doppler indices from the last available fetal echo were collected, including pattern and velocity of the umbilical artery (UA), umbilical vein (UV), ductus venosus (DV), and middle cerebral artery (MCA). Pulsatility and resistive indices (PI and RI) of the UA and MCA as well as cerebroplacental ratio (CPR) were calculated. The primary outcome was perinatal mortality, defined as fetal demise or neonatal death prior to discharge. Univariable and multivariable analyses were performed with the aforementioned predictors of mortality.ResultsOf 243 cases, 213 had umbilical Doppler data and 96 had all extracardiac Doppler indices for analysis. At a mean GA of 30.2 ± 6 weeks, 12.2% had abnormal UA, 14.8% abnormal UV, 18.8% abnormal DV, and 7.4% abnormal MCA patterns. The presence of PR was highly associated with increased UA PI (P
ISSN:0009-7322
1524-4539