Prenatal Predictors of Postnatal Outcome in PA/IVS

PI: Mike Puchalski, University of Utah 

We aim to collaborate with other members of the Fetal Heart Society to describe a large cohort of fetuses with pulmonary atresia and intact ventricular septum in order to investigate predictors of poor perinatal outcomes in this population. In addition, we would like to evaluate differences in longitudinal pre-natal growth of cardiac structures in patients who ultimately end up with single vs two ventricle circulations.


 

Mitral Valve Regurgitation in the Fetus

PI: Shaine Morris, Texas Children’s Hospital

We aim to collaborate with other members of the Fetal Heart Society to describe a large cohort of fetuses with normal cardiac connections and moderate to severe mitral valve regurgitation, and to investigate predictors of poor perinatal outcomes in this population. One of our secondary goals is to better describe the recently delineated “mitral valve dysplasia complex” that is characterized by a restrictive or intact atrial septum, dysplastic and incompetent mitral valve, aortic annular hypoplasia and dilated left ventricle.


Fetal anatomy and physiology and associations with fetal and perinatal outcomes in D-transposition of the great arteries with intact ventricular septum, a multicenter, multi-arm, prospective study

Primary Investigators:

  • Anatomic/ Physiologic: Joyce Johnson, Lurie Children’s Hospital of Chicago
  • Myocardial Mechanics: Jacqueline Shuplock, Monroe Carell Jr. Children’s Hospital at Vanderbilt 
  • Hyperoxia: David Schidlow, Children’s National Medical Center, Washington, D.C.

This study aims to characterize prenatal anatomic and physiologic features of D-transposition of the great arteries with intact ventricular septum (TGA/IVS) and associations with outcomes.

Anatomic Arm Aim:  To identify prenatal anatomic and physiologic characteristics of D-transposition of the great arteries (TGA) and their associations with fetal and postnatal outcomes.

Hyperoxia Arm Aim:  Describe the physiologic and anatomic response to maternal hyperoxygenation (MH) in fetuses with TGA and its associations with fetal and postnatal outcomes.  Secondarily, describe the middle cerebral artery response to MH in fetuses with TGA.

Strain Arm Aim:  Define myocardial strain patterns in fetuses with TGA and their associations with fetal and postnatal outcomes.


 

Impact of socioeconomic and geographic factors on prenatal diagnosis of hypoplastic left heart syndrome (HLHS) and d-transposition of the great arteries (d-TGA)

PI: Anita Krishnan, Children’s National Medical Center, Washington, D. C.

This study aims to:

  • Determine whether poverty level, government insurance, vulnerable race and ethnic group, and at risk geographic locations are associated with lower rates of prenatal diagnosis of hypoplastic left heart syndrome (HLHS).
  • Determine whether poverty level, government insurance, vulnerable race and ethnic group, and at risk geographic locations are associated with lower rates of prenatal diagnosis of transposition of the great arteries (TGA).

Risk stratification in advanced twin-twin transfusion syndrome: the importance of mitral regurgitation

PI: Shiraz Maskatia, Lucile Packard Children’s Hospital, Stanford

This study aims to:

  1. Define the incidence of mitral regurgitation in the setting of advanced twin-twin transfusion syndrome.
  2. Define the association between mitral regurgitation and perinatal mortality and morbidity in monochorionic, diamniotic twin fetuses with advanced (Stage III-IV) twin-twin transfusion syndrome and compare the strength of the association of mitral regurgitation with perinatal mortality to other identified risk factors in this disease process.

 

 

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