Fifty Five Fetuses with D-TGA and their Follow-Up in Single Fetal Cardiac Tertiary Center and Review of the Data from Polish National Registry for Fetal Cardiac Anomalies (WWW.Orkp.Pl)

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In the Polish National Registry for Fetal Cardiac Pathology d-TGA ranked in 5th place on the list of most common heart defects after HLHS, AVSD, VSD and TOF and accounted for 3,5% of all registered cardiac malformations. The following increase in the detection of d-TGA in Poland was observed: 8 fetuses in 2006, 20 fetuses in 2008, 30 fetuses in 2012 (p<0,05, McNemara test).

The aim of this study was to analyze selected fetal and neonatal data in a group of 55 patients with d-TGA in the years 1997-2012 in the single reference prenatal cardiology center, type C (> 120 prenatal CHD per year). Mean gestational age was 28,2+/-4,7 weeks, which decreased from 36st week (in 2007) to 30th week (in 2012) (p=0,006; ANOVA & post hoc NIR test).

Demise in utero, termination of pregnancy, demise before cardiac surgery (4%) and postoperative deaths (2%) were taken into account (p >0,05 test χ2). Rashkind procedure during 48h after delivery was performed in 36% of neonates.

Conclusion: In the past 12 years we have observed a tendency to better detection of prenatal d-TGA (p <0,05) and to identify d-TGA at earlier gestational age (p=0,006). “Hidden mortality” (before surgery) was higher than postoperative mortality in the neonatal period, however statistically the difference was not significant (p>0,05).

1. Allan LD, Sharland GK, Milburn A, Lockhart SM, Groves AMM, Anderson RH, Cook AC, Fagg NLK: Prospective diagnosis of 1,006 consecutive cases of congenital heart disease in the fetus. J Am Coll Cardiol. 1994;23:1452-1458

2. Bonnet D, Coltri A, Butera G, Fermont L, Le Bidois J, Kachaner J, Sidi D: Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality. Circulation. 1999 Feb 23;99(7):916-8

3. Respondek-Liberska M: Nagroda im. Dr Andrzeja Respondka i wada serca płodu d-TGA. Ultrasonografia 2011, 11, 46, 61-65

4. Vinals F, Heredia F, Giuliano A: The role of the three vessels and trachea view (3VT) in the diagnosis of congenital heart defects. Ultrasound Obstet Gynecol. 2003 Oct;22(4):358-67

5. Vinals F, Ascenzo R, Poblete P, Comas C, Vargas G, Giuliano A: Simple approach to prenatal diagnosis of transposition of the great arteries. Ultrasound Obstet Gynecol. 2006 Jul;28(1):22-5

6. Yagel S, Arbel R, Anteby EY, Raveh D, Achiron R: The three vessels and trachea view (3VT) in fetal cardiac scanning. Ultrasound Obstet Gynecol. 2002 Oct;20(4):340-5

7. Zalel Y, Wiener Y, Gamzu R, Herman A, Schiff E, Achiron R: The three-vessel and tracheal view of the fetal heart: an in utero sonographic evaluation. Prenat Diagn. 2004 Mar;24(3):174-8

8. Paladini D, Sglavo G, Greco E, Nappi C: Cardiac screening by STIC: can sonologists performing the 20-week anomaly scan pick up outflow tract abnormalities by scrolling the A-plane of STIC volumes? Ultrasound Obstet Gynecol. 2008 Dec;32(7):865-70

9. Włoch A, Włoch S, Sikora J, Bakon I, Rokicki W: Analysis of cases with fetal extrasystole coexisting with cardiac and extracardiac pathology. Ginekol Pol. 2003 Jun;74(6):456-62

10. Respondek-Liberska M. i wsp: Kardiologia prenatalna dla położnikow. Czelej. Lublin 2006.

11. Respondek-Liberska M: Atlas wad serca płodu. ADI ART Łodź 2011.

12. Szymkiewicz-Dangel J: Kardiologia Płodu. Zasady diagnostyki i terapii. Ośrodek Wydawnictw Naukowych. Poznań 2007.

13. Pinto NM, Keenan HT, Minich LL, Puchalski MD, Heywood M, Botto LD: Barriers to prenatal detection of congenital heart disease: a population-based study. Ultrasound Obstet Gynecol. 2012 40(4): 418-25

14. Blyth M, Howe D, Gnanapragasam J, Wellesley D. The hidden mortality of transposition of the great arteries and survival advantage provided by prenatal diagnosis. BJOG. 2008 Aug;115(9):1096-100.

15. Maeno YV, Kamenir SA, Sinclair B, van der Velde ME, Smallhorn JF, Hornberger LK: Prenatal features of ductus arteriosus constriction and restrictive foramen ovale in d-transposition of the great arteries. Circulation. 1999 Mar 9;99(9):1209-14

16. Jouannic JM, Gavard L, Fermont L, Le Bidois J, Parat S, Vouhe PR, Dumez Y, Sidi D, Bonnet D: Sensitivity and specificity of prenatal features of physiological shunts to predict neonatal clinical status in transposition of the great arteries. Circulation. 2004 Sep 28;110(13):1743-6

17. Nakajima J, Kawakami T, Takeuchi K, Tsuchiya K: Dextro- Transposition of the Great Arteries in a Neonate with Ventricular Septal Defect and Pulmonary Stenosis Complicated by Premature Closure of the Ductus Arteriosus and Possible Pathophysiology of Both Defects. Pediatr Cardiol. 2012 Nov 2. [Epub ahead of print].

18. Kirklin JW, Blackstone EH, Tchervenkov CI, Castaneda AR.: Clinical outcomes after the arterial switch operation for transposition: patient, support, procedural, and institutional risk factors. Circulation. 1992;86:1501-1515

19. Nevvazhay T, Chernogrivov A, Biryukov E, Biktasheva L, Karchevskaya K, Sulejmanov S, Kalinicheva J, Artemiev N: Arterial switch in the first hours of life: no need for Rashkind septostomy? Eur J Cardiothorac Surg. 2012 Sep;42(3):520-3

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