The impact of not having a ductus arteriosus on clinical outcomes in foetuses diagnosed with tetralogy of Fallot

Seth J. Stern, Neelum Wadekar, Luc Mertens, Cedric Manlhiot, Brian W. McCrindle, Edgar T. Jaeggi, Lynne E. Nield

Research output: Contribution to journalArticle

Abstract

Background: Foetuses with simple tetralogy of Fallot almost universally have a patent ductus arteriosus. Two recently identified cases had an absent patent ductus arteriosus, requiring emergent intervention at birth. The objective of this study was to determine whether foetuses diagnosed with tetralogy of Fallot and no patent ductus arteriosus have poorer outcomes compared with those with tetralogy of Fallot + patent ductus arteriosus. Methods: All foetal cases of tetralogy of Fallot between January, 2000 and 2012 were retrospectively identified from The Hospital for Sick Children (Toronto, Canada) database. Cases - tetralogy of Fallot + no patent ductus arteriosus confirmed on postnatal echo - and controls - tetralogy of Fallot + patent ductus arteriosus, matched for gestational age - were identified from prenatal records, and both clinical and echocardiographic data were reviewed. Optimal outcome was defined as valve-sparing repair with no residual lesions. Student's t-tests and Fisher's exact χ2 were used to compare groups. Results: n=115 foetuses were diagnosed with tetralogy of Fallot: 11 (9%) had no patent ductus arteriosus, and were matched to 22 controls - mean gestational age at diagnosis 23.2 ± 4.2 weeks, 23.4 ± 6.6 weeks, respectively. Cases had a higher proportion of right aortic arches (64% versus 14%, p<0.001). Foetal and postnatal echocardiographic data did not reveal significant differences in branch pulmonary artery sizes, pulmonary valve sizes, or ventricular function. No differences were identified for cyanosis at birth (2/10 versus 7/20, p=0.67), or catheter intervention (5/10 versus 4/22, p=0.12). Optimal outcome rates were similar between cases and controls (4/11 (36%) versus 5/21 (24%), p=0.68). Conclusions: The patent ductus arteriosus does not appear to have an impact on clinical outcome in foetuses with tetralogy of Fallot.

Original languageEnglish (US)
Pages (from-to)684-692
Number of pages9
JournalCardiology in the young
Volume25
Issue number4
DOIs
StatePublished - Jun 23 2015
Externally publishedYes

Fingerprint

Ductus Arteriosus
Patent Ductus Arteriosus
Tetralogy of Fallot
Fetus
Gestational Age
Parturition
Pulmonary Valve
Cyanosis
Ventricular Function
Thoracic Aorta
Pulmonary Artery
Canada
Catheters
Databases
Students

Keywords

  • ductus arteriosus
  • foetal echocardiography
  • outcome
  • Tetralogy of Fallot

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

The impact of not having a ductus arteriosus on clinical outcomes in foetuses diagnosed with tetralogy of Fallot. / Stern, Seth J.; Wadekar, Neelum; Mertens, Luc; Manlhiot, Cedric; McCrindle, Brian W.; Jaeggi, Edgar T.; Nield, Lynne E.

In: Cardiology in the young, Vol. 25, No. 4, 23.06.2015, p. 684-692.

Research output: Contribution to journalArticle

Stern, Seth J. ; Wadekar, Neelum ; Mertens, Luc ; Manlhiot, Cedric ; McCrindle, Brian W. ; Jaeggi, Edgar T. ; Nield, Lynne E. / The impact of not having a ductus arteriosus on clinical outcomes in foetuses diagnosed with tetralogy of Fallot. In: Cardiology in the young. 2015 ; Vol. 25, No. 4. pp. 684-692.
@article{af348005b3514628be632dd037ebc599,
title = "The impact of not having a ductus arteriosus on clinical outcomes in foetuses diagnosed with tetralogy of Fallot",
abstract = "Background: Foetuses with simple tetralogy of Fallot almost universally have a patent ductus arteriosus. Two recently identified cases had an absent patent ductus arteriosus, requiring emergent intervention at birth. The objective of this study was to determine whether foetuses diagnosed with tetralogy of Fallot and no patent ductus arteriosus have poorer outcomes compared with those with tetralogy of Fallot + patent ductus arteriosus. Methods: All foetal cases of tetralogy of Fallot between January, 2000 and 2012 were retrospectively identified from The Hospital for Sick Children (Toronto, Canada) database. Cases - tetralogy of Fallot + no patent ductus arteriosus confirmed on postnatal echo - and controls - tetralogy of Fallot + patent ductus arteriosus, matched for gestational age - were identified from prenatal records, and both clinical and echocardiographic data were reviewed. Optimal outcome was defined as valve-sparing repair with no residual lesions. Student's t-tests and Fisher's exact χ2 were used to compare groups. Results: n=115 foetuses were diagnosed with tetralogy of Fallot: 11 (9{\%}) had no patent ductus arteriosus, and were matched to 22 controls - mean gestational age at diagnosis 23.2 ± 4.2 weeks, 23.4 ± 6.6 weeks, respectively. Cases had a higher proportion of right aortic arches (64{\%} versus 14{\%}, p<0.001). Foetal and postnatal echocardiographic data did not reveal significant differences in branch pulmonary artery sizes, pulmonary valve sizes, or ventricular function. No differences were identified for cyanosis at birth (2/10 versus 7/20, p=0.67), or catheter intervention (5/10 versus 4/22, p=0.12). Optimal outcome rates were similar between cases and controls (4/11 (36{\%}) versus 5/21 (24{\%}), p=0.68). Conclusions: The patent ductus arteriosus does not appear to have an impact on clinical outcome in foetuses with tetralogy of Fallot.",
keywords = "ductus arteriosus, foetal echocardiography, outcome, Tetralogy of Fallot",
author = "Stern, {Seth J.} and Neelum Wadekar and Luc Mertens and Cedric Manlhiot and McCrindle, {Brian W.} and Jaeggi, {Edgar T.} and Nield, {Lynne E.}",
year = "2015",
month = "6",
day = "23",
doi = "10.1017/S1047951114000638",
language = "English (US)",
volume = "25",
pages = "684--692",
journal = "Cardiology in the Young",
issn = "1047-9511",
publisher = "Cambridge University Press",
number = "4",

}

TY - JOUR

T1 - The impact of not having a ductus arteriosus on clinical outcomes in foetuses diagnosed with tetralogy of Fallot

AU - Stern, Seth J.

AU - Wadekar, Neelum

AU - Mertens, Luc

AU - Manlhiot, Cedric

AU - McCrindle, Brian W.

AU - Jaeggi, Edgar T.

AU - Nield, Lynne E.

PY - 2015/6/23

Y1 - 2015/6/23

N2 - Background: Foetuses with simple tetralogy of Fallot almost universally have a patent ductus arteriosus. Two recently identified cases had an absent patent ductus arteriosus, requiring emergent intervention at birth. The objective of this study was to determine whether foetuses diagnosed with tetralogy of Fallot and no patent ductus arteriosus have poorer outcomes compared with those with tetralogy of Fallot + patent ductus arteriosus. Methods: All foetal cases of tetralogy of Fallot between January, 2000 and 2012 were retrospectively identified from The Hospital for Sick Children (Toronto, Canada) database. Cases - tetralogy of Fallot + no patent ductus arteriosus confirmed on postnatal echo - and controls - tetralogy of Fallot + patent ductus arteriosus, matched for gestational age - were identified from prenatal records, and both clinical and echocardiographic data were reviewed. Optimal outcome was defined as valve-sparing repair with no residual lesions. Student's t-tests and Fisher's exact χ2 were used to compare groups. Results: n=115 foetuses were diagnosed with tetralogy of Fallot: 11 (9%) had no patent ductus arteriosus, and were matched to 22 controls - mean gestational age at diagnosis 23.2 ± 4.2 weeks, 23.4 ± 6.6 weeks, respectively. Cases had a higher proportion of right aortic arches (64% versus 14%, p<0.001). Foetal and postnatal echocardiographic data did not reveal significant differences in branch pulmonary artery sizes, pulmonary valve sizes, or ventricular function. No differences were identified for cyanosis at birth (2/10 versus 7/20, p=0.67), or catheter intervention (5/10 versus 4/22, p=0.12). Optimal outcome rates were similar between cases and controls (4/11 (36%) versus 5/21 (24%), p=0.68). Conclusions: The patent ductus arteriosus does not appear to have an impact on clinical outcome in foetuses with tetralogy of Fallot.

AB - Background: Foetuses with simple tetralogy of Fallot almost universally have a patent ductus arteriosus. Two recently identified cases had an absent patent ductus arteriosus, requiring emergent intervention at birth. The objective of this study was to determine whether foetuses diagnosed with tetralogy of Fallot and no patent ductus arteriosus have poorer outcomes compared with those with tetralogy of Fallot + patent ductus arteriosus. Methods: All foetal cases of tetralogy of Fallot between January, 2000 and 2012 were retrospectively identified from The Hospital for Sick Children (Toronto, Canada) database. Cases - tetralogy of Fallot + no patent ductus arteriosus confirmed on postnatal echo - and controls - tetralogy of Fallot + patent ductus arteriosus, matched for gestational age - were identified from prenatal records, and both clinical and echocardiographic data were reviewed. Optimal outcome was defined as valve-sparing repair with no residual lesions. Student's t-tests and Fisher's exact χ2 were used to compare groups. Results: n=115 foetuses were diagnosed with tetralogy of Fallot: 11 (9%) had no patent ductus arteriosus, and were matched to 22 controls - mean gestational age at diagnosis 23.2 ± 4.2 weeks, 23.4 ± 6.6 weeks, respectively. Cases had a higher proportion of right aortic arches (64% versus 14%, p<0.001). Foetal and postnatal echocardiographic data did not reveal significant differences in branch pulmonary artery sizes, pulmonary valve sizes, or ventricular function. No differences were identified for cyanosis at birth (2/10 versus 7/20, p=0.67), or catheter intervention (5/10 versus 4/22, p=0.12). Optimal outcome rates were similar between cases and controls (4/11 (36%) versus 5/21 (24%), p=0.68). Conclusions: The patent ductus arteriosus does not appear to have an impact on clinical outcome in foetuses with tetralogy of Fallot.

KW - ductus arteriosus

KW - foetal echocardiography

KW - outcome

KW - Tetralogy of Fallot

UR - http://www.scopus.com/inward/record.url?scp=84924435027&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84924435027&partnerID=8YFLogxK

U2 - 10.1017/S1047951114000638

DO - 10.1017/S1047951114000638

M3 - Article

C2 - 24775715

AN - SCOPUS:84924435027

VL - 25

SP - 684

EP - 692

JO - Cardiology in the Young

JF - Cardiology in the Young

SN - 1047-9511

IS - 4

ER -