Prenatal diagnosis and treatment planning of congenital heart defects-possibilities and limits

Nelle, M; Raio, L; Pavlovic, M; Carrel, T; Surbek, D; Meyer-Wittkopf, M (2009). Prenatal diagnosis and treatment planning of congenital heart defects-possibilities and limits. World journal of pediatrics WJP, 5(1), pp. 18-22. Hangzhou: Springer-Verlag 10.1007/s12519-009-0003-8

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BACKGROUND: Newborns with hypoplastic left heart syndrome (HLHS) or right heart syndrome or other malformations with a single ventricle physiology and associated hypoplasia of the great arteries continue to be a challenge in terms of survival. The vast majority of these forms of congenital heart defects relate to abnormal morphogenesis during early intrauterine development and can be diagnosed accurately by fetal echocardiography. Early knowledge of these conditions not only permits a better understanding of the progression of these malformations but encourages some researchers to explore new minimally invasive therapeutic options with a view to early pre- and postnatal cardiac palliation. DATA SOURCES: PubMed database was searched with terms of "congenital heart defects", "fetal echocardiography" and "neonatal cardiac surgery". RESULTS: At present, early prenatal detection has been applied for monitoring pregnancy to avoid intrauterine cardiac decompensation. In principle, the majority of congenital heart defects can be diagnosed by prenatal echocardiography and the detection rate is 85%-95% at tertiary perinatal centers. The majority, particularly of complex congenital lesions, show a steadily progressive course including subsequent secondary phenomena such as arrhythmias or myocardial insufficiency. So prenatal treatment of an abnormal fetus is an area of perinatal medicine that is undergoing a very dynamic development. Early postnatal treatment is established for some time, and prenatal intervention or palliation is at its best experimental stage in individual cases. CONCLUSION: The upcoming expansion of fetal cardiac intervention to ameliorate critically progressive fetal lesions intensifies the need to address issues about the adequacy of technological assessment and patient selection as well as the morbidity of those who undergo these procedures.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Nelle, Mathias; Raio, Luigi; Pavlovic, Mladen; Carrel, Thierry; Surbek, Daniel and Meyer-Wittkopf, Matthias

ISSN:

1708-8569

Publisher:

Springer-Verlag

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:06

Last Modified:

23 Oct 2019 07:56

Publisher DOI:

10.1007/s12519-009-0003-8

PubMed ID:

19172327

Web of Science ID:

000262917900003

BORIS DOI:

10.7892/boris.28589

URI:

https://boris.unibe.ch/id/eprint/28589 (FactScience: 121935)

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