- Risk Stratification in advanced twin-twin transfusion syndrome: the importance of mitral regurgitation
- Primary Investigators:
- Shiraz Maskatia, MD | Lucile Packard Children’s Hospital, Palo Alto, California
- Anita Moon-Grady, MD | University of California San Francisco, San Francisco, California
- Specific Aims:
- Define the incidence of mitral regurgitation in the setting of advanced twin-twin transfusion syndrome.
- Define the association of 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 association of mitral regurgitation with perinatal mortality to other identified risk factors in this disease process.
- Primary Investigators:
- Impact of socioeconomic and geographic factors on prenatal diagnosis of hypoplastic left heart syndrome (HLHS) and d-transposition of the great arteries (d-TGA)
- Primary Investigator:
- Anita Krishnan MD | Children’s National Health System, Washington DC
- Specific 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).
- 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 transposition of the great arteries (TGA).
- Primary Investigator:
- Mitral valve regurgitation in the fetus
- Primary Investigators:
- Shaine Morris, MD | Baylor College of Medicine, Houston, Texas
- Betul Yilmaz, MD | Baylor College of Medicine, Houston, Texas
- Specific Aims:
- To describe a large cohort of fetuses with congenital moderate to severe mitral valve regurgitation, either in isolation or in combination with other left-sided obstructive lesions/conditions such as congenital aortic annular hypoplasia or valvar stenosis.
- To describe longitudinal changes in mitral regurgitation and fetal hemodynamics in fetuses with serial studies.
- To determine what prenatal echocardiographic features in congenital mitral valve regurgitation are associated with a) fetal survival b) neonatal survival after live birth (survival to 28 days of life) c) fetal or neonatal survival (overall survival to 28 days including fetal death) d) survival to discharge e) overall survival.
- To describe fetal interventions that have been performed to date in these fetuses and to describe outcomes in this subpopulation.
- To describe fetal strain values in this population subset of studies for which this is able to be collected and to compare them to reference valuesImproved knowledge of the population and outcomes with mitral valve regurgitation will help 1) aid in prenatal counseling, and 2) guide future management decisions for fetuses diagnosed with mitral valve regurgitation. We propose that identification of this unique cardiovascular finding will allow us to develop novel strategies to improve outcomes for this patient population.
- Prenatal Predictors of Postnatal Outcome in Pulmonary Atresia with Intact Ventricular Septum: A Multicenter Study
- Primary Investigator:
- Michael Puchalski, MD | Johns Hopkins All Children’s, Saint Petersburg, Florida
- Specific Aims:
- To identify fetal echocardiographic predictors of post-natal outcomes (type of post-natal circulation and survival) in PA/IVS
- Hypothesis: Fetal echocardiographic anatomic features (partite nature of the RV, degree of tricuspid regurgitation and presence/absence of coronary sinusoids), measurements (Z-scores of right heart structures and pulmonary arteries), as well as Doppler indices will help determine the eventual post-natal circulation (biventricular, uni-ventricular and one-and-half ventricle repair) and transplant free survival up to 5-year of age in patients with PA/IVS.
- Evaluate the longitudinal pre-natal growth of right heart structures and pulmonary arteries in biventricular, univentricular and one-and-half ventricle group.
- Hypothesis: Longitudinal pre-natal growth of right heart structures and pulmonary arteries in the biventricular groups will be higher than the univentricular or one-and-half ventricle groups. We will use gestational age corrected Z-scores and right-left heart structure ratios to account for prenatal changes in right heart structure.
- Primary Investigator:
- Primary Investigators:
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