TY - JOUR
T1 - Cardiac Function Assessments in Left Bochdalek’s Hernia
T2 - Clinical Relevance
AU - Sehgal, Arvind
AU - Tan, Kenneth
AU - Ferguson, Peter
PY - 2018/4/1
Y1 - 2018/4/1
N2 - The objectives of this study were to characterize peri-operative echocardiographic (ECHO) assessments of right ventricular (RV) function and pulmonary hypertension (PH) and ascertain correlation with clinical outcomes in infants with left Bochdalek’s hernia (LBH). This retrospective study in a quaternary neonatal intensive care unit involved electronic database search for infants with LBH during January 2009 to July 2017. Demographics, outcomes, and ECHO parameters were accessed from archived databases. Thirty-one infants with mean gestational age and birthweight (BW) 38.4 ± 1.4 weeks and 3079 ± 450 g were included. Postnatal age at surgery was 4.3 ± 2 days. Two infants died before surgery (none after surgery). The survival rate in this cohort of late preterm and term infants with LBH not accompanied by congenital heart disease was 29/31 (93.5%). PH was noted in 28 (90%). Significant changes in biventricular function and pulmonary vascular haemodynamics were noted when reassessed after surgery [RV area change (%), 28 ± 3 vs. 34 ± 4, p = 0.007 and pulmonary artery capacitance (PAC) (ml3 × mmHg−1), 0.05 ± 0.03 vs. 0.09 ± 0.05, p = 0.02]. The median duration of all respiratory support in those who were operated was 14.7 days (8.5, 25). Significant correlations were noted between pre-operative ECHO assessments and the duration of respiratory support (tricuspid regurgitation, r = 0.63, p = 0.0001 and PAC, r = − 0.52, p = 0.004). Peri-operative functional ECHO provided information about the evolution of cardiac function in infants with LBH.
AB - The objectives of this study were to characterize peri-operative echocardiographic (ECHO) assessments of right ventricular (RV) function and pulmonary hypertension (PH) and ascertain correlation with clinical outcomes in infants with left Bochdalek’s hernia (LBH). This retrospective study in a quaternary neonatal intensive care unit involved electronic database search for infants with LBH during January 2009 to July 2017. Demographics, outcomes, and ECHO parameters were accessed from archived databases. Thirty-one infants with mean gestational age and birthweight (BW) 38.4 ± 1.4 weeks and 3079 ± 450 g were included. Postnatal age at surgery was 4.3 ± 2 days. Two infants died before surgery (none after surgery). The survival rate in this cohort of late preterm and term infants with LBH not accompanied by congenital heart disease was 29/31 (93.5%). PH was noted in 28 (90%). Significant changes in biventricular function and pulmonary vascular haemodynamics were noted when reassessed after surgery [RV area change (%), 28 ± 3 vs. 34 ± 4, p = 0.007 and pulmonary artery capacitance (PAC) (ml3 × mmHg−1), 0.05 ± 0.03 vs. 0.09 ± 0.05, p = 0.02]. The median duration of all respiratory support in those who were operated was 14.7 days (8.5, 25). Significant correlations were noted between pre-operative ECHO assessments and the duration of respiratory support (tricuspid regurgitation, r = 0.63, p = 0.0001 and PAC, r = − 0.52, p = 0.004). Peri-operative functional ECHO provided information about the evolution of cardiac function in infants with LBH.
KW - Bochdalek
KW - Cardiac function
KW - Diaphragmatic hernia
KW - Echocardiography
KW - Outcome
KW - Pulmonary hypertension
UR - http://www.scopus.com/inward/record.url?scp=85042361582&partnerID=8YFLogxK
U2 - 10.1007/s00246-018-1834-7
DO - 10.1007/s00246-018-1834-7
M3 - Article
C2 - 29473101
AN - SCOPUS:85042361582
VL - 39
SP - 829
EP - 836
JO - Pediatric Cardiology
JF - Pediatric Cardiology
SN - 0172-0643
IS - 4
ER -