Key result
The fetal foramen ovale index provided 100% sensitivity, and the index multiplied by diameter provided 100% specificity for predicting the need for urgent balloon atrial septostomy in d-TGA.
Why the study?
This study aimed to identify new functional echocardiographic features of the fetal foramen ovale to predict the need for urgent balloon atrial septostomy in neonates with simple d-TGA.
Does functional echocardiographic assessment of the fetal foramen ovale predict the need for urgent balloon atrial septostomy in fetuses with simple d-TGA?
Observational (n=12)
No
Does functional echocardiographic assessment of the fetal foramen ovale predict the need for urgent balloon atrial septostomy in fetuses with simple d-TGA?
Fetal foramen ovale index and its product with FO diameter assessed by M-mode echocardiography in the 3rd trimester may accurately predict the need for urgent postnatal balloon atrial septostomy in simple d-TGA.
OBJECTIVE: This study aimed to identify new functional echocardiographic features of fetal foramen ovale (FO) to predict the need of urgent balloon atrial septostomy (BAS) in neonates with simple dextro-transposition of the great arteries (d-TGA). METHOD: Single-center prospective study of fetuses, who had prenatal echocardiographic examination <30 days before delivery and fetal diagnosis of simple d-TGA. The subjects were divided according to the need of BAS within the first 24 h after neonatal birth and before arterial switch operation. We analyzed following parameters: FO diameter, pulmonary venous maximal velocity, new FO flap tracings index analyzed by M-mode echocardiography. RESULTS: Out of 130 fetuses, 12 patients were included. Cutoff value of FO index provided maximum sensitivity (100%) and negative predictive value (100%) and cutoff value of FO index multiplied by FO diameter provided maximum specificity (100%) and positive predictive value (100%) in fetuses with fetal d-TGA in predicting need of urgent BAS. CONCLUSION: FO index could potentially be used to predict postnatal haemodynamic stability in fetuses with simple d-TGA. FO index multiplied by FO diameter could potentially be used to predict prenatally the need of urgent BAS following the birth.
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Sylwestrzak et al. (2022) conducted an observational in simple dextro-transposition of the great arteries (d-TGA) (n=12). Fetal foramen ovale (FO) index and FO diameter was evaluated on Need of urgent balloon atrial septostomy (BAS) within the first 24 h after neonatal birth. The fetal foramen ovale index provided 100% sensitivity, and the index multiplied by diameter provided 100% specificity for predicting the need for urgent balloon atrial septostomy in d-TGA.
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