RESUMO
OBJECTIVES: We sought to describe the implementation and effectiveness of a statewide fetal tele-echocardiography program serving a resource-limited population. STUDY DESIGN: In 2009, our heart center established six satellite clinics for fetal tele-echocardiography around the state. We retrospectively reviewed all fetal tele-echocardiograms performed through 2018. Yearly statewide prenatal detection rates of operable congenital heart disease were queried from the Society of Thoracic Surgeons database. RESULT: In 1164 fetuses, fetal tele-echocardiography identified all types of congenital heart disease, with a sensitivity of 74% and specificity of 97%. For the detection of ductal-dependent congenital heart disease, fetal tele-echocardiography was 100% sensitive and specific. Between 2009 and 2018, annual statewide prenatal detection rates of congenital heart disease requiring heart surgery in the first 6 months of life rose by 159% (17-44%; R2 = 0.88, p < 0.01). CONCLUSIONS: The present study provides a framework for an effective, large-scale fetal tele-echocardiography program.
Assuntos
Cardiopatias Congênitas , Ultrassonografia Pré-Natal , Ecocardiografia , Feminino , Feto , Cardiopatias Congênitas/diagnóstico por imagem , Humanos , Gravidez , Estudos RetrospectivosRESUMO
The absence of the pulmonary valve in connection with tricuspid atresia and intact ventricular septum is a rare malformation, associated with a poor prognosis. The right ventricle is severely hypertrophied, resembling a cardiac mass protruding into the left ventricular outflow tract. We report such a case that underwent successful palliation with a Blalock-Taussig shunt followed by a superior cavopulmonary anastomosis.
Assuntos
Anormalidades Múltiplas , Valva Pulmonar/anormalidades , Atresia Tricúspide/complicações , Septo Interventricular , Procedimento de Blalock-Taussig , Ecocardiografia Doppler , Ecocardiografia Tridimensional , Derivação Cardíaca Direita , Humanos , Hipertrofia Ventricular Direita/diagnóstico , Hipertrofia Ventricular Direita/etiologia , Recém-Nascido , Masculino , Cuidados Paliativos , Valva Pulmonar/diagnóstico por imagem , Valva Pulmonar/cirurgia , Resultado do Tratamento , Atresia Tricúspide/diagnóstico , Atresia Tricúspide/cirurgiaRESUMO
A female neonate presented with evidence of a massive ventilation-perfusion mismatch. She was subsequently found to have a saddle pulmonary embolus. The infant successfully underwent surgical pulmonary embolectomy.