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July 29, 2015Prenatal Diagnosis

Fetal aortic valve stenosis: a critique of case selection criteria for fetal intervention

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Key result

The eHLHS score reliably predicted postnatal management, with no fetus having a full score achieving biventricular repair and all 7 with an unfavorable score (<4) undergoing a univentricular pathway.

Why the study?

Do published 'eHLHS' and threshold scores predict postnatal management pathways in fetuses with aortic stenosis?

Population

31 consecutive fetuses with aortic stenosis (AS) evaluated at a tertiary fetal cardiology centre.

Design

Cohort

Follow-up

postnatal

Authors

LHLindsey HunterHCHenry ChubbOMOwen Miller

Discussion

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Overview

May inform prenatal counseling on repair pathways in fetal AS; leaves open prospective validation before guiding management.

Study Design

Type

Observational (n=31)

Multicenter

No

Structured PICO

Do published 'eHLHS' and threshold scores predict postnatal management pathways in fetuses with aortic stenosis?

P
Population
31 consecutive fetuses with aortic stenosis evaluated retrospectively at a single tertiary fetal cardiology centre.
E
Exposure
Application of published 'eHLHS' scores and threshold scores based on fetal echocardiographic findings.
O
Outcome
Postnatal management (biventricular repair versus single ventricle palliation).hard clinical

The eHLHS score is a reliable predictor for progression to hypoplastic left heart syndrome at term and helps identify fetuses likely to require a single ventricle pathway postnatally.

Cite This Study

Hunter et al. (2015) conducted an observational in Fetal aortic stenosis (n=31). eHLHS and threshold scoring systems was evaluated on Postnatal management (biventricular repair versus single ventricle palliation). The eHLHS score reliably predicted postnatal management, with no fetus having a full score achieving biventricular repair and all 7 with an unfavorable score (<4) undergoing a univentricular pathway.

synapsesocial.com/papers/6a7da90b33dcb27c99cb5293https://doi.org/10.1002/pd.4661
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Natural history and outcome of aortic stenosis diagnosed prenatally.1997 · 189 citations
  2. 2Predictors of Technical Success and Postnatal Biventricular Outcome After In Utero Aortic Valvuloplasty for Aortic Stenosis With Evolving Hypoplastic Left Heart Syndrome2009 · 313 citations
  3. 3Changes in left heart hemodynamics after technically successful <i>in‐utero</i> aortic valvuloplasty2007 · 96 citations
  4. 4Percutaneous Fetal Cardiac Interventions for Structural Heart Disease2014 · 32 citations
  5. 5Persistent pulmonary hypertension late after neonatal aortic valvotomy: a consequence of an expanded surgical cohort2004 · 29 citations