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Behera SK, Ding VY, Chung S, Tacy TA. Impact of Fetal Echocardiogram Comprehensiveness on Diagnostic Accuracy. J Am Soc Echocardiogr 2022; 35:752-761.e11. [DOI: 10.1016/j.echo.2022.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/26/2022] [Accepted: 02/27/2022] [Indexed: 10/18/2022]
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Evans WN, Acherman RJ, Ciccolo ML, Lehoux J, Rothman A, Galindo A. Detecting Critical Congenital Heart Disease in Nevada. World J Pediatr Congenit Heart Surg 2019; 10:702-706. [DOI: 10.1177/2150135119873847] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: We reviewed data on patients born with critical congenital heart disease in the state of Nevada and analyzed detection via prenatal diagnosis versus newborn pulse oximetry screening, location of birth, and gestational age at birth. Methods: We inquired our databases and electronic health records for all patients with critical congenital heart disease born in Nevada between January 2016 and May 2019. Results: We identified 218 live born patients. Of the 218, average gestational age was 38 weeks (±2.2 weeks). Of the 218, 171 (78%) were prenatally diagnosed, 37 (17%) were diagnosed by immediate postnatal signs and symptoms, 8 (4%) had false-negative pulse oximetry screens that resulted in post-hospital discharge presentations, and 2 (1%) had positive pulse oximetry screens. The eight post-hospital discharge presentations included four in extremis, two with extreme cyanosis, and two dying at home. Of the 171 prenatally diagnosed patients, 157 (92%) were born at the Nevada hospital with the congenital cardiac unit. Conclusion: To the best of our knowledge, our results represent the highest statewide, general population prenatal detection of critical congenital heart disease in the United States. Our high prenatal detection rate led to the majority of patients being born at the Nevada facility with the congenital heart unit, limiting intrastate neonatal transports. On average, patients were born at term. Further, in Nevada, state-mandated, universal pulse oximetry screening resulted in more false-negative results than positive results
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Affiliation(s)
- William N. Evans
- Children’s Heart Center Nevada, Las Vegas, NV, USA
- Division of Pediatric Cardiology, Department of Pediatrics, University of Nevada, Las Vegas School of Medicine, NV, USA
| | - Ruben J. Acherman
- Children’s Heart Center Nevada, Las Vegas, NV, USA
- Division of Pediatric Cardiology, Department of Pediatrics, University of Nevada, Las Vegas School of Medicine, NV, USA
| | - Michael L. Ciccolo
- Children’s Heart Center Nevada, Las Vegas, NV, USA
- Department of Surgery, University of Nevada, Las Vegas School of Medicine, NV, USA
| | - Juan Lehoux
- Children’s Heart Center Nevada, Las Vegas, NV, USA
| | - Abraham Rothman
- Children’s Heart Center Nevada, Las Vegas, NV, USA
- Division of Pediatric Cardiology, Department of Pediatrics, University of Nevada, Las Vegas School of Medicine, NV, USA
| | - Alvarao Galindo
- Children’s Heart Center Nevada, Las Vegas, NV, USA
- Division of Pediatric Cardiology, Department of Pediatrics, University of Nevada, Las Vegas School of Medicine, NV, USA
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Zhu Y, Zhang Y, Ding N, Zhao Y, Ye Z, Fan X, Liu Y, Shen L, Yi H, Li Z. The role of cardiac surgeons in online prenatal counselling for congenital heart disease. J Int Med Res 2019; 47:5270-5277. [PMID: 31452428 PMCID: PMC6833391 DOI: 10.1177/0300060519869079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective To explore the role of cardiac surgeons in prenatal online counselling for congenital heart disease. Methods From January 2014 to December 2017, the author consulted on 400 cases of foetal cardiovascular abnormalities through the Good Doctor Online and WeChat online platforms. The author made appropriate pregnancy recommendations to patients and families using patient ultrasound reports and medical histories. Followed-up patients who chose to continue their pregnancy received postnatal advice. Results There were 248 simple cardiac abnormalities and 152 complex cardiac abnormalities. Foetal chromosome examination detected 2 cases of trisomy 21 syndrome and 26 normal cases. Two mothers (0.8%) of simple cardiac abnormality foetuses and 103 (67.8%) mothers of complex cardiac abnormality foetuses chose induced abortion. A total of 246 mothers of simple cardiac abnormality foetuses chose to continue pregnancy and had good postnatal prognosis. Twenty-six mothers of complex cardiac abnormality foetuses chose to continue pregnancy; among these, there were 4 intrauterine deaths, 22 births, 4 deaths while awaiting surgery and 18 successful surgeries. Conclusion The Good Doctor Online and WeChat platforms facilitate communication with a wide audience. Cardiac surgeons can reduce the birth incidence and improve prenatal consultations for severe congenital heart disease through these platforms.
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Affiliation(s)
- Yaobin Zhu
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yaping Zhang
- Department of Heart Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Nan Ding
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yudong Zhao
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zankai Ye
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xing Fan
- Pediatric Heart Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yang Liu
- Pediatric Heart Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lei Shen
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hanlu Yi
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhiqiang Li
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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