Featured Research

from universities, journals, and other organizations

In a challenging infant heart defect, two-thirds may have high chance of survival

Date:
October 29, 2010
Source:
Children's Hospital of Philadelphia
Summary:
When prenatal diagnosis detects the severe heart defect hypoplastic left heart syndrome (HLHS) in a fetus, a comprehensive prenatal evaluation is important to provide parents an accurate prognosis. In HLHS, one of the heart's pumping chambers is severely underdeveloped. However, researchers say, in two-thirds of cases, reconstructive surgery affords the infant an excellent chance of early survival.

When prenatal diagnosis detects the severe heart defect hypoplastic left heart syndrome (HLHS) in a fetus, a comprehensive prenatal evaluation is important to provide parents an accurate prognosis. In HLHS, one of the heart's pumping chambers is severely underdeveloped. However, say researchers, in two-thirds of cases, reconstructive surgery affords the infant an excellent chance of early survival.

Researchers from The Children's Hospital of Philadelphia report on five years of experience at that hospital, in a review of 240 fetuses diagnosed with HLHS from 2004 to 2009. Children's Hospital has some of the world's longest and most extensive experience in performing staged surgical repair of HLHS.

"Because we have offered this type of reconstructive heart surgery for over 25 years, our goal was to establish a benchmark for perinatal and early surgical outcome in the present era," said Jack Rychik, M.D., medical director of the Fetal Heart Program at Children's Hospital.

Rychik was the primary investigator of the study, published in the October issue of the journal Ultrasound in Obstretrics and Gynecology.

In HLHS, one of the most common forms of congenital heart disease diagnosed before birth, the underdeveloped left ventricle is unable to properly circulate blood. Over the past 25 years, surgeons at Children's Hospital of Philadelphia and elsewhere have developed and refined reconstructive surgery -- currently a series of three planned procedures, beginning in the newborn period and extending to 1 to 4 years of age. Although outcomes vary broadly worldwide, overall survival rates for children with HLHS have steadily improved.

In the current study the researchers classified 162 (68 percent) of the 240 fetuses as standard-risk, and 78 of them (32 percent) as high-risk. In high-risk cases, in addition to the severely underdeveloped left ventricle, the fetus also had genetic and chromosomal defects, prematurity, or other heart abnormalities.

Of the 240 fetuses diagnosed with HLHS, 185 newborns underwent the first stage of surgery, called the Norwood procedure, resulting in 155 survivors and 30 deaths. Within those overall figures, 93 percent of standard-risk cases survived the first operation, compared to 57 percent of high-risk cases.

The Children's Hospital of Philadelphia typically employs a staged surgical approach for fetuses diagnosed with HLHS, says Rychik, but at that center and elsewhere, some parents choose to terminate a pregnancy or to decline medical intervention at birth. The current study, he says, may provide clarity to families and caregivers in categorizing the degree of mortality risk from this condition.

"Surgical outcomes for HLHS are in-part related to patient volume, institutional experience, and the availability of dedicated resources," said Rychik. "However, we found a striking survival advantage for the standard-risk fetuses compared to the higher-risk cases. Two-thirds of fetuses with HLHS do not have a higher-risk form of the condition, and have a stronger chance of survival. After an initial prenatal diagnosis of HLHS, we strongly encourage families to receive a comprehensive evaluation including amniocentesis, so they may obtain a more accurate prognosis. In this way, families can have the best information during prenatal counseling by which to make their plans for the future of their fetus and newborn child."

"Our current research and clinical efforts are focused on improving the quality of life and long-term survival for this group of patients, including dedicated follow-up programs for the evaluation and treatment of cardiac and non-cardiac outcomes," said Gil Wernovsky, M.D., associate chief of cardiology and director of the NeuroCardiac Care Program at Children's Hospital. He added, "Many of these children will face life-long challenges as they mature, and we are committed to understanding and improving these on-going issues as our patients grow."

Dr. Rychik receives funding for his research work through the Robert and Delores Harrington Endowed Chair for Pediatric Cardiology at The Children's Hospital of Philadelphia.

Dr. Rychik's co-authors were Anita Szwast, M.D.; Shoba Natarajan, M.D.; Michael Quartermain, M.D.; Denise Donaghue, R.N. M.S.N.; Jill Combs, R.N., M.S.N.; J. William Gaynor, M.D.; Peter Gruber, M.D.; Thomas Spray, M.D.; Michael Bebbington, M.D.; and Mark Johnson, M.D.; all of The Children's Hospital of Philadelphia.


Story Source:

The above story is based on materials provided by Children's Hospital of Philadelphia. Note: Materials may be edited for content and length.


Cite This Page:

Children's Hospital of Philadelphia. "In a challenging infant heart defect, two-thirds may have high chance of survival." ScienceDaily. ScienceDaily, 29 October 2010. <www.sciencedaily.com/releases/2010/10/101026121746.htm>.
Children's Hospital of Philadelphia. (2010, October 29). In a challenging infant heart defect, two-thirds may have high chance of survival. ScienceDaily. Retrieved July 29, 2014 from www.sciencedaily.com/releases/2010/10/101026121746.htm
Children's Hospital of Philadelphia. "In a challenging infant heart defect, two-thirds may have high chance of survival." ScienceDaily. www.sciencedaily.com/releases/2010/10/101026121746.htm (accessed July 29, 2014).

Share This




More Health & Medicine News

Tuesday, July 29, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Deadly Ebola Virus Threatens West Africa

Deadly Ebola Virus Threatens West Africa

AP (July 28, 2014) West African nations and international health organizations are working to contain the largest Ebola outbreak in history. It's one of the deadliest diseases known to man, but the CDC says it's unlikely to spread in the U.S. (July 28) Video provided by AP
Powered by NewsLook.com
$15B Deal on Vets' Health Care Reached

$15B Deal on Vets' Health Care Reached

AP (July 28, 2014) A bipartisan deal to improve veterans health care would authorize at least $15 billion in emergency spending to fix a veterans program scandalized by long patient wait times and falsified records. (July 28) Video provided by AP
Powered by NewsLook.com
Two Americans Contract Ebola in Liberia

Two Americans Contract Ebola in Liberia

Reuters - US Online Video (July 28, 2014) Two American aid workers in Liberia test positive for Ebola while working to combat the deadliest outbreak of the virus ever. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Traditional African Dishes Teach Healthy Eating

Traditional African Dishes Teach Healthy Eating

AP (July 28, 2014) Classes are being offered nationwide to encourage African Americans to learn about cooking fresh foods based on traditional African cuisine. The program is trying to combat obesity, heart disease and other ailments often linked to diet. (July 28) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins