Fetal echocardiography in Lithuania: traditions, significance and problems

Background. The discovery of ultrasound has made a revolution in almost all fields of medicine. The past three decades have withessed an intensive development of fetal echocardiography methods and technique. The aim of the paper is to present a review of the results and trends of the last 10 years of fetal echocardiography in Lithuania and to show the spectrum and outcomes of prenatally detected congenital heart diseases. Materials and methods. Fetal echocardiography was performed for 1816 fetuses during the period from 1999 to 2009. Results. Cardiac pathology was diagnosed in 176 (9.7%) fetuses. Heart defects were detected in 112 (63.6%) of them, cardiac rhythm and conduction disturbances in 62 (35.2%), cardiomyopathy in 2 (1.1%) fetuses, and heart rhabdomyoma in 1 (0.6%) fetus. The general rate of the postnatal diagnosis of congenital heart defects in Lithuania was about 10%. Most of fetal cardiac diseases (70.5%) were diagnosed after 22 weeks of gestation. Because most of antenatally diagnosed congenital heart defects (74%) were critical and inconsistent with life, a large part of newborns (40.2%) died in the neonatal period, 10.7% of fetuses died in utero, and 8% of pregnancies were terminated by abortion. The data demonstrate good tendencies: the diagnosis has become earlier, a wider spectrum of diseases have been diagnosed, more newborns have survived. Our survey shows that 41.1% of newborns with prenatally diagnosed congenital heart defects have survived. Conclusions. 10% of severe congenital heart diseases are detected prenatally in Lithuania. The efficacy of antenatal diagnostics depends on the qualification of specialists, the number of tertiary care centers, on a successful collaboration among pediatric cardiologists, obstetricians and geneticists. The main problem is an insufficient preparation of obstetricians, the uncertified favor of pediatric cardiologist. Keywords: congenital heart disease, fetal echocardiography, antenatal diagnostics

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Screening for congenital heart defects: diversified strategies in current China

World Journal of Pediatric Surgery ◽

10.1136/wjps-2019-000051 ◽

2019 ◽

Vol 2 (1) ◽

pp. e000051 ◽

Cited By ~ 1

Author(s):

Xiwang Liu ◽

Weize Xu ◽

Jiangen Yu ◽

Qiang Shu

Keyword(s):

Pulse Oximetry ◽

Congenital Heart Defects ◽

Congenital Heart ◽

Heart Diseases ◽

Fetal Echocardiography ◽

Heart Defects ◽

Financial Burden ◽

Multiple Perspectives ◽

Medical Resources ◽

Indicator Method

BackgroundCongenital heart defects (CHD) is the most common type of birth defect and a leading cause of infant mortality in China. Detection of CHD during newborn is still challenging. The contradiction between the increasingly mature technology of diagnosis and treatment and the inability of early detection is the biggest current dilemma. A few pilot studies attempt to establish the universal screening for CHD in newborns; however, the rate of misdiagnosis is still high in most Chinese hospitals, especially in some undeveloped middle-western regions.Data sourcesBased on the recent publications on screening of congenital heart diseases in China. We reviewed the use of diversified screening strategies in current China.ResultsPrenatal diagnosis by fetal echocardiography and postnatal detection by pulse oximetry combined with clinical assessment are the useful methods for CHD screening in most areas. The altitude should be taken into account when using pulse oximetry in the middle-western areas of China, where the incidence of CHD maybe higher. Echocardiography is suitable for CHD screening in almost all areas but it could add to financial burden in the developing regions. Genetic analysis could assist clinical doctors to perform more earlier screening and give better counseling regarding the outcome. Due to disparities in economic and medical resources, the screening system should be carried out from multiple perspectives according to the present economic development. Notably, follow-up is an important issue in the screening of CHD, especially for the asymptomatic babies who discharged home. Policies should be formulated to address the epidemiology of CHD in deprived areas to better allocate medical resources and to develop local training programmes to screen and diagnose CHD.ConclusionsDiversified strategies are available in current China. The two-indicator method for CHD screening is recommended to be implemented in routine postnatal care. We can do more in screening for CHD in the future.

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Naujagimių įgimtų širdies ydų chirurgija: Vilniaus universiteto Širdies chirurgijos centro patirtis

Lietuvos chirurgija ◽

10.15388/lietchirur.2007.3.2209 ◽

2007 ◽

Vol 5 (3) ◽

pp. 0-0

Author(s):

Virgilijus Lebetkevičius ◽

Virgilijus Tarutis ◽

Rita Sudikienė ◽

Daina Liekienė ◽

Kęstutis Lankutis ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Congenital Heart Defects ◽

Congenital Heart ◽

Heart Surgery ◽

Heart Diseases ◽

Heart Defects ◽

University Hospital ◽

Congenital Heart Diseases ◽

Corrective Surgery ◽

Vilnius University

Virgilijus Lebetkevičius1, Virgilijus Tarutis1, Rita Sudikienė1, Daina Liekienė1, Kęstutis Lankutis1, Giedrė Nogienė1, Vidmantas Jonas Žilinskas1, Vytautas Sirvydis1, Kęstutis Versockas2, Žydrė Jurgelienė2, Asta Bliūdžiūtė21 Vilniaus universiteto Širdies chirurgijos centras, Santariškių g. 2, LT-08661 Vilnius2 Vilniaus universiteto ligoninės Santariškių klinikų Anesteziologijos,intensyviosios terapijos ir skausmo gydymo centras, Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Tikslas Apžvelgti Vilniaus universiteto Širdies chirurgijos centro naujagimių įgimtų širdies ydų chirurgijos rezultatus, juos įvertinti ir padaryti išvadas. Metodai Nuo 1964 iki 2006 metų Vilniaus universiteto Širdies chirurgijos centre atlikta 5066 įgimtų širdies ydų operacijos vaikams iki 18 metų. Naujagimių dalis – 307 operacijos (6,1%). Korekcijos naujagimiams atliktos naudojant dirbtinę kraujo apytaką (DKA) ir be jos. Rezultatai Įgimtų širdies ydų operacijos suskirstytos į keturis etapus. 1974–1990 metai (1974 m. atlikta pirmoji širdies operacija naujagimiui). Tuo laikotarpiu mirštamumas buvo 100%. 1991–1995 metais – mirštamumas 71%, 1996–2000 metais – mirštamumas 68%, 2001–2006 metais – mirštamumas 38%, 2006 metais mirštamumas – 22%. Išvados Analizuojant naujagimių širdies chirurgijos rezultatus, pažymėtina, kad per pastaruosius metus mirštamumas sumažėjo iki priimtinų dydžių, kurie artėja prie kitų pasaulio širdies chirurgijos klinikų rezultatų. Gerėjant visam kompleksui tyrimo, gydymo, slaugymo priemonių visose grandyse (kardiologija, anesteziologija-reanimatologija, chirurgija), mirštamumą įmanoma sumažinti iki minimalaus. Pagrindiniai žodžiai: įgimtos širdies ydos, širdies chirurgija, naujagimiai Corrective surgery of congenital heart defects: experience of Vilnius University Heart Surgery Centre Virgilijus Lebetkevičius1, Virgilijus Tarutis1, Rita Sudikienė1, Daina Liekienė1, Kęstutis Lankutis1, Giedrė Nogienė1, Vidmantas Jonas Žilinskas1, Vytautas Sirvydis1, Kęstutis Versockas2, Žydrė Jurgelienė2, Asta Bliūdžiūtė21 Vilnius University, Heart Surgery Centre, Santariškių str. 2, LT-08661 Vilnius2 Vilnius University Hospital „Santariškių klinikos“, Anaesthesiology Intensive Careand Pain Management Centre, Santariškių str. 2, LT-08661 VilniusE-mail: [email protected] Objective To access the outcome and mortality trend in newborns undergoing corrective surgery for congenital heart defect. Methods We reviewed the hospital records on 307 neonates under 30 days of life, who had congenital heart defects operated on at the Heart Surgery Center of Vilnius University, Lithuania, in 1994 through 2006. Early and late mortality results were analyzed. Results From January 1974 to 2006, 307 neonates with congenital heart disease underwent surgical repair at Heart Surgery Clinic of Vilnius University. It came to 6.1% of all 5066 procedures of the congenital heart diseases performed. The number of neonate operations considerably increased in the later years, because a special department with proper technique was established. 144 neonates underwent surgery repair with cardiopulmonary bypass and 163 neonates were operated on without cardiopulmonary bypass. The mean age of the patients was 11.8 ± 0.28 days. There were 113 girls and 194 boys. Conclusions Mortality from 71% in 1991–1995 dropped to 38% in 2001–2006 and 22% in 2006. Key words: congenital heart diseases, cardiosurgery, neonates

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Spectrum of congenital heart disease in neonates in a tertiary care centre of Northern India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20182554 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1505

Author(s):

Mahvish Qazi ◽

Najmus Saqib

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart Defects ◽

Congenital Heart ◽

Cleft Lip ◽

Heart Diseases ◽

Heart Defects ◽

Tertiary Care ◽

Mode Of Delivery ◽

Tertiary Care Centre

Background: Congenital heart defects (CHDs) are an important cause of mortality and morbidity in children representing a major global health burden. Not much of Indian data is available particularly from this part of the country. So, authors conduct a retrospective study to know the spectrum of congenital heart disease in our set up.Methods: A retrospective hospital based study was carried out in the neonatal intensive care unit of SMGS Hospital, Jammu from January 2017 until December 2017 to see the spectrum of CHD.Results: There were 5552 neonates admitted during the study period out of which 68 were found to have CHD. The prevalence was 12.24 per 1000 admitted neonates. Out of 68 admitted neonates, 41were males (60.3 %) and 27 females (39.7%). Clinically Respiratory distress (51.47%) was the commonest presenting symptom followed by Cyanosis (16.18%), refusal of feed (13.23%) and murmer (10.3%).46 (67.65%) newborn had acyanotic and 22 (32.35%) cyanotic congenital heart lesions. Ventricular septal defect (27.94%) was the commonest acyanotic congenital heart defects whereas Tetrology of Fallot (14.70%) was the commonest cyanotic congenital heart diseases. Cleft lip and Cleft Palate was found in 12.5% followed by Down’s syndrome in 3.57% of cases of newborns with CHD. The mode of delivery was spontaneous in 64.71% followed by Elective LSCS were 23.53% and Emergency LSCS were 11.76%.Conclusions: There is an urgent need for government and non‑government organizations to establish well‑equipped cardiothoracic surgical centers across the country especially in Jammu to cater for children with CHDs.

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Fetal echocardiography - 25-year experience in Serbia

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh180130018v ◽

2019 ◽

Vol 147 (1-2) ◽

pp. 70-73

Author(s):

Svetlana Vrzic-Petronijevic ◽

Milos Petronijevic ◽

Vojislav Parezanovic ◽

Jelena Stamenkovic-Dukanac ◽

Zorica Jestrovic ◽

...

Keyword(s):

Congenital Heart Defect ◽

Congenital Heart ◽

Fetal Heart ◽

Heart Diseases ◽

Fetal Echocardiography ◽

Heart Defects ◽

Pathological Finding ◽

Congenital Heart Diseases ◽

Heart Defect ◽

Specificity And Sensitivity

Introduction/Objective. Congenital heart diseases are the most common congenital anomalies. The objective of the study was to determine reliability, specificity, and sensitivity of fetal echocardiography in detection of congenital heart diseases in a referral center for fetal echocardiography. Methods. We analyzed 14,500 fetal echocardiography exams (FEC) between 1991 and 2014, performed in two tertiary centers. Results. The average maternal age at the time of diagnosis was 32 years. The mean gestational age at the time of diagnosis was 25.9 weeks. The most common indications for FEC were suspicious abnormal cardiac findings in obstetrical screening sonography (50.6%). Among 9,055 examined fetuses, pathological finding on the fetal heart was found in 638 cases. The most common congenital heart diseases were structural anomalies of the fetal heart in 81%, of which 13.3% were fetuses with hypoplastic left heart syndrome and 11.2% with ventricular septal defect. Of all fetuses with diagnosed congenital heart defect, 46.2% were born alive and had good postnatal prognosis, while 2.7% died in utero, and 10.6% died in the early neonatal period. Pregnancy was terminated in 40.4% of fetuses with severe congenital heart defect. Sensitivity of the diagnostic procedure in our study was 95.9%, and specificity was 99.9%. Conclusion. Our study proves that FEC is a reliable, informative diagnostic tool in detecting congenital heart defects with high specificity and sensitivity. With multidisciplinary approach, it provides an optimal time window for improving perinatal outcome.

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Catching congenital heart diseases early : the ten- point approach for Bhutan

Bhutan Health Journal ◽

10.47811/bhj.32 ◽

2016 ◽

Vol 2 (2) ◽

pp. 34-36

Author(s):

Purushotam Bhandari

Keyword(s):

Congenital Heart Defects ◽

Birth Defect ◽

Congenital Heart ◽

School Health ◽

Sick Child ◽

Heart Diseases ◽

Heart Defects ◽

Congenital Heart Diseases ◽

Pediatric Residents ◽

Delayed Initiation

Congenital heart disease is the most common birth defect and is the main reason for out country referral of pediatric patients from Bhutan. Given the limited resources and expertise, detecting congenital heart defects is often delayed, resulting in delayed initiation of treatment and management of associated complications. Congenital heart diseases, if detected early, can be appropriately treated and complications minimized. A ten-point approach consisting of antenatal diagnosis, neonatal pulse oximetry, well child visits, sick child visits, immunization clinics, school health checkups, pediatric echocardiographers, pediatric cardiologists, basic echocardiography skills in pediatric residents and comprehensive birth defect surveillance is suggested, in order to catch congenital heart defects early in life.

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Personalized Genetic Diagnosis of Congenital Heart Defects in Newborns

Journal of Personalized Medicine ◽

10.3390/jpm11060562 ◽

2021 ◽

Vol 11 (6) ◽

pp. 562

Author(s):

Olga María Diz ◽

Rocio Toro ◽

Sergi Cesar ◽

Olga Gomez ◽

Georgia Sarquella-Brugada ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart Defects ◽

Congenital Malformations ◽

Congenital Heart ◽

Heart Diseases ◽

Heart Defects ◽

Genetic Diagnosis ◽

Single Nucleotide Variants ◽

Personalized Approach

Congenital heart disease is a group of pathologies characterized by structural malformations of the heart or great vessels. These alterations occur during the embryonic period and are the most frequently observed severe congenital malformations, the main cause of neonatal mortality due to malformation, and the second most frequent congenital malformations overall after malformations of the central nervous system. The severity of different types of congenital heart disease varies depending on the combination of associated anatomical defects. The causes of these malformations are usually considered multifactorial, but genetic variants play a key role. Currently, use of high-throughput genetic technologies allows identification of pathogenic aneuploidies, deletions/duplications of large segments, as well as rare single nucleotide variants. The high incidence of congenital heart disease as well as the associated complications makes it necessary to establish a diagnosis as early as possible to adopt the most appropriate measures in a personalized approach. In this review, we provide an exhaustive update of the genetic bases of the most frequent congenital heart diseases as well as other syndromes associated with congenital heart defects, and how genetic data can be translated to clinical practice in a personalized approach.

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Spectrum of Congenital Heart Diseases in a Tertiary Care Centre, Mysuru, Karnataka

Indian Journal of Public Health Research & Development ◽

10.37506/ijphrd.v11i7.10156 ◽

2020 ◽

Keyword(s):

Congenital Heart ◽

Heart Diseases ◽

Tertiary Care ◽

Congenital Heart Diseases ◽

Care Centre ◽

Tertiary Care Centre

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Facts about the General Medical Care of Adults with Congenital Heart Defects: Experience of a Tertiary Care Center

Journal of Clinical Medicine ◽

10.3390/jcm9061943 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1943

Author(s):

Lavinia Seidel ◽

Kathrin Nebel ◽

Stephan Achenbach ◽

Ulrike Bauer ◽

Peter Ewert ◽

...

Keyword(s):

Heart Disease ◽

Medical Care ◽

Primary Care Physicians ◽

Congenital Heart ◽

Heart Defects ◽

Care Center ◽

Tertiary Care ◽

Care Practice ◽

Cross Sectional ◽

Almost All

Background: Due to the increase in survival rates for congenital heart disease (CHD) in the last decades, over 90% of patients today reach adulthood. Currently, there are more than 300,000 adults with CHD (ACHD) living in Germany. They have an increased need for specialized medical care, since almost all ACHD have chronic heart disease and suffer from specific chronic symptoms, risks, and sequelae. Primary care physicians (PCPs) play a crucial role in referring patients to ACHD specialists or specialized institutions. This cross-sectional study is intended to clarify the real-world care of ACHD from the PCP’s perspective. Methods: This analysis, initiated by the German Heart Centre Munich, was based on a 27-item questionnaire on actual ACHD health care practice in Germany from the PCP’s perspective. Results: In total, 767 questionnaires were considered valid for inclusion. The majority of the PCPs were general practitioners (95.9%), and 84.1% had cared for ACHD during the past year. A majority (69.2%) of the PCPs had cared for patients with simple CHD, while 50.6% and 33.4% had cared for patients with moderate and severe CHD, respectively, in all age groups. PCPs treated almost all typical residual symptoms and sequelae, and advised patients regarding difficult questions, including exercise capacity, pregnancy, genetics, and insurance matters. However, 33.8% of the PCPs did not even know about the existence of certified ACHD specialists or centers. Only 23.9% involved an ACHD-specialized physician in their treatment. In cases of severe cardiac issues, 70.8% of the PCPs referred patients to ACHD-certified centers. Although 52.5% of the PCPs were not sufficiently informed about existing structures, 64.2% rated the current care situation as either “very good” or “good”. Only 26.3% (n = 190) of the responding physicians were aware of patient organizations for ACHD. Conclusions: The present study showed that the majority of PCPs are not informed about the ACHD care structures available in Germany. The need for specialized ACHD follow-up care is largely underestimated, with an urgent need for optimization to reduce morbidity and mortality. For the future, solutions must be developed to integrate PCPs more intensively into the ACHD care network.

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