Prenatal diagnosis of congenital heart disease affects preoperative acidosis in the newborn patient

Paul M. Verheijen, Lukas A. Lisowski, Phillip Stoutenbeek, J. François Hitchcock, Joel Brenner, Joshua A. Copel, Charles S. Kleinman, Erik J. Meijboom, Ger B W E Bennink

Research output: Contribution to journalArticle

Abstract

Objectives: Congenital heart disease is the leading cause of death in the first year after birth. Prenatal diagnosis of the disease can optimize the preoperative condition of the patient and may help in the prevention of acidosis. In this retrospective study we compared the occurrence of metabolic acidosis in patients with and without prenatal diagnosis of a congenital heart disease. Methods: Data of 408 patients who needed an operation for congenital heart disease within 31 days of life were analyzed retrospectively. Arterial blood gases at fixed time intervals and worst blood gas of 81 patients with and 327 patients without a prenatal diagnosis were compared, categorizing the patients on ductus dependency, anticipated univentricular or biventricular repair, and left-sided, right-sided, or no heart obstruction. Results: In the overall group significant differences in lowest pH, lowest base excess, and highest lactate level were found, with metabolic acidosis more common among the patients with a postnatal diagnosis. In the group of patients with ductus-dependent congenital heart disease, the difference between patients receiving a prenatal and those receiving a postnatal diagnosis was more significant than in the group with non-ductus-dependent lesions. Analyzing patients with right-sided, left-sided, and no obstruction separately, significant differences were found in the group with left-sided heart obstruction for lowest pH and base excess and in the group with right-sided heart obstruction for lowest base excess. Conclusions: Prenatal diagnosis of congenital heart disease minimizes metabolic acidosis in patients with congenital heart disease and may be associated with improved long-term outcome and prevention of cerebral damage among this fragile group of patients, although no significant effect on direct surgical outcome was encountered.

Original languageEnglish (US)
Pages (from-to)798-803
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume121
Issue number4
DOIs
StatePublished - Apr 1 2001
Externally publishedYes

Fingerprint

Acidosis
Prenatal Diagnosis
Heart Diseases
Newborn Infant
Gases
Patient Rights
Cause of Death
Lactic Acid
Retrospective Studies
Parturition

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Verheijen, P. M., Lisowski, L. A., Stoutenbeek, P., Hitchcock, J. F., Brenner, J., Copel, J. A., ... Bennink, G. B. W. E. (2001). Prenatal diagnosis of congenital heart disease affects preoperative acidosis in the newborn patient. Journal of Thoracic and Cardiovascular Surgery, 121(4), 798-803. https://doi.org/10.1067/mtc.2001.112825

Prenatal diagnosis of congenital heart disease affects preoperative acidosis in the newborn patient. / Verheijen, Paul M.; Lisowski, Lukas A.; Stoutenbeek, Phillip; Hitchcock, J. François; Brenner, Joel; Copel, Joshua A.; Kleinman, Charles S.; Meijboom, Erik J.; Bennink, Ger B W E.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 121, No. 4, 01.04.2001, p. 798-803.

Research output: Contribution to journalArticle

Verheijen, PM, Lisowski, LA, Stoutenbeek, P, Hitchcock, JF, Brenner, J, Copel, JA, Kleinman, CS, Meijboom, EJ & Bennink, GBWE 2001, 'Prenatal diagnosis of congenital heart disease affects preoperative acidosis in the newborn patient', Journal of Thoracic and Cardiovascular Surgery, vol. 121, no. 4, pp. 798-803. https://doi.org/10.1067/mtc.2001.112825
Verheijen, Paul M. ; Lisowski, Lukas A. ; Stoutenbeek, Phillip ; Hitchcock, J. François ; Brenner, Joel ; Copel, Joshua A. ; Kleinman, Charles S. ; Meijboom, Erik J. ; Bennink, Ger B W E. / Prenatal diagnosis of congenital heart disease affects preoperative acidosis in the newborn patient. In: Journal of Thoracic and Cardiovascular Surgery. 2001 ; Vol. 121, No. 4. pp. 798-803.
@article{81facf06418348f9847deb5ae0881fbe,
title = "Prenatal diagnosis of congenital heart disease affects preoperative acidosis in the newborn patient",
abstract = "Objectives: Congenital heart disease is the leading cause of death in the first year after birth. Prenatal diagnosis of the disease can optimize the preoperative condition of the patient and may help in the prevention of acidosis. In this retrospective study we compared the occurrence of metabolic acidosis in patients with and without prenatal diagnosis of a congenital heart disease. Methods: Data of 408 patients who needed an operation for congenital heart disease within 31 days of life were analyzed retrospectively. Arterial blood gases at fixed time intervals and worst blood gas of 81 patients with and 327 patients without a prenatal diagnosis were compared, categorizing the patients on ductus dependency, anticipated univentricular or biventricular repair, and left-sided, right-sided, or no heart obstruction. Results: In the overall group significant differences in lowest pH, lowest base excess, and highest lactate level were found, with metabolic acidosis more common among the patients with a postnatal diagnosis. In the group of patients with ductus-dependent congenital heart disease, the difference between patients receiving a prenatal and those receiving a postnatal diagnosis was more significant than in the group with non-ductus-dependent lesions. Analyzing patients with right-sided, left-sided, and no obstruction separately, significant differences were found in the group with left-sided heart obstruction for lowest pH and base excess and in the group with right-sided heart obstruction for lowest base excess. Conclusions: Prenatal diagnosis of congenital heart disease minimizes metabolic acidosis in patients with congenital heart disease and may be associated with improved long-term outcome and prevention of cerebral damage among this fragile group of patients, although no significant effect on direct surgical outcome was encountered.",
author = "Verheijen, {Paul M.} and Lisowski, {Lukas A.} and Phillip Stoutenbeek and Hitchcock, {J. Fran{\cc}ois} and Joel Brenner and Copel, {Joshua A.} and Kleinman, {Charles S.} and Meijboom, {Erik J.} and Bennink, {Ger B W E}",
year = "2001",
month = "4",
day = "1",
doi = "10.1067/mtc.2001.112825",
language = "English (US)",
volume = "121",
pages = "798--803",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Prenatal diagnosis of congenital heart disease affects preoperative acidosis in the newborn patient

AU - Verheijen, Paul M.

AU - Lisowski, Lukas A.

AU - Stoutenbeek, Phillip

AU - Hitchcock, J. François

AU - Brenner, Joel

AU - Copel, Joshua A.

AU - Kleinman, Charles S.

AU - Meijboom, Erik J.

AU - Bennink, Ger B W E

PY - 2001/4/1

Y1 - 2001/4/1

N2 - Objectives: Congenital heart disease is the leading cause of death in the first year after birth. Prenatal diagnosis of the disease can optimize the preoperative condition of the patient and may help in the prevention of acidosis. In this retrospective study we compared the occurrence of metabolic acidosis in patients with and without prenatal diagnosis of a congenital heart disease. Methods: Data of 408 patients who needed an operation for congenital heart disease within 31 days of life were analyzed retrospectively. Arterial blood gases at fixed time intervals and worst blood gas of 81 patients with and 327 patients without a prenatal diagnosis were compared, categorizing the patients on ductus dependency, anticipated univentricular or biventricular repair, and left-sided, right-sided, or no heart obstruction. Results: In the overall group significant differences in lowest pH, lowest base excess, and highest lactate level were found, with metabolic acidosis more common among the patients with a postnatal diagnosis. In the group of patients with ductus-dependent congenital heart disease, the difference between patients receiving a prenatal and those receiving a postnatal diagnosis was more significant than in the group with non-ductus-dependent lesions. Analyzing patients with right-sided, left-sided, and no obstruction separately, significant differences were found in the group with left-sided heart obstruction for lowest pH and base excess and in the group with right-sided heart obstruction for lowest base excess. Conclusions: Prenatal diagnosis of congenital heart disease minimizes metabolic acidosis in patients with congenital heart disease and may be associated with improved long-term outcome and prevention of cerebral damage among this fragile group of patients, although no significant effect on direct surgical outcome was encountered.

AB - Objectives: Congenital heart disease is the leading cause of death in the first year after birth. Prenatal diagnosis of the disease can optimize the preoperative condition of the patient and may help in the prevention of acidosis. In this retrospective study we compared the occurrence of metabolic acidosis in patients with and without prenatal diagnosis of a congenital heart disease. Methods: Data of 408 patients who needed an operation for congenital heart disease within 31 days of life were analyzed retrospectively. Arterial blood gases at fixed time intervals and worst blood gas of 81 patients with and 327 patients without a prenatal diagnosis were compared, categorizing the patients on ductus dependency, anticipated univentricular or biventricular repair, and left-sided, right-sided, or no heart obstruction. Results: In the overall group significant differences in lowest pH, lowest base excess, and highest lactate level were found, with metabolic acidosis more common among the patients with a postnatal diagnosis. In the group of patients with ductus-dependent congenital heart disease, the difference between patients receiving a prenatal and those receiving a postnatal diagnosis was more significant than in the group with non-ductus-dependent lesions. Analyzing patients with right-sided, left-sided, and no obstruction separately, significant differences were found in the group with left-sided heart obstruction for lowest pH and base excess and in the group with right-sided heart obstruction for lowest base excess. Conclusions: Prenatal diagnosis of congenital heart disease minimizes metabolic acidosis in patients with congenital heart disease and may be associated with improved long-term outcome and prevention of cerebral damage among this fragile group of patients, although no significant effect on direct surgical outcome was encountered.

UR - http://www.scopus.com/inward/record.url?scp=0035323937&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035323937&partnerID=8YFLogxK

U2 - 10.1067/mtc.2001.112825

DO - 10.1067/mtc.2001.112825

M3 - Article

C2 - 11279423

AN - SCOPUS:0035323937

VL - 121

SP - 798

EP - 803

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 4

ER -