Evidence map›Paper›PMID 37219587›Full record

ArticlePediatric cardiology2023

Medium-term Outcome of Prenatally Diagnosed Hypoplastic Left-Heart Syndrome and Impact of a Restrictive Atrial Septum Diagnosed in-utero.

Tristan Ramcharan, Diana B Quintero, John Stickley, Esther Poole, Paul Miller, Tarak Desai, Michael Harris, Mark D Kilby, Oliver Stumper, Natasha Khan and 2 more

Abstract read
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Article in Pediatric cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Tristan RamcharanHeart Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Diana B QuinteroHeart Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
John StickleyHeart Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Esther PooleHeart Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Paul MillerHeart Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Tarak DesaiHeart Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Michael HarrisHeart Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Mark D KilbyFetal Medicine Centre, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Oliver StumperHeart Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Natasha KhanHeart Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
David J BarronHeart Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Anna N SealeHeart Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK. annaseale@nhs.net.
Birmingham Women’s and Children’s NHS Foundation Trust · GBIllumina (United Kingdom) · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSurgical outcome data differs from overall outcomes of prenatally diagnosed fetuses with hypoplastic left heart syndrome (HLHS). Our aim was to describe outcome of prenatally diagnosed fetuses with this anomaly.

methodsRetrospective review of prenatally diagnosed classical HLHS at a tertiary hospital over a 13-year period, estimated due dates 01/08/2006 to 31/12/2019. HLHS-variants and ventricular disproportion were excluded.

results203 fetuses were identified with outcome information available for 201. There were extra-cardiac abnormalities in 8% (16/203), with genetic variants in 14% of those tested (17/122). There were 55 (27%) terminations of pregnancy, 5 (2%) intrauterine deaths and 10 (5%) babies had prenatally planned compassionate care. There was intention to treat (ITT) in the remaining 131/201(65%). Of these, there were 8 neonatal deaths before intervention, two patients had surgery in other centers. Of the other 121 patients, Norwood procedure performed in 113 (93%), initial hybrid in 7 (6%), and 1 had palliative coarctation stenting. Survival for the ITT group from birth at 6-months, 1-year and 5-years was 70%, 65%, 62% respectively. Altogether of the initial 201 prenatally diagnosed fetuses, 80 patients (40%) are currently alive. A restrictive atrial septum (RAS) is an important sub-category associated with death, HR 2.61, 95%CI 1.34-5.05, p = 0.005, with only 5/29 patients still alive.

conclusionMedium-term outcomes of prenatally diagnosed HLHS have improved however it should be noted that almost 40% do not get to surgical palliation, which is vital to those doing fetal counselling. There remains significant mortality particularly in fetuses with in-utero diagnosed RAS.

Indexed as

Atrial SeptumHypoplastic Left Heart SyndromeNorwood ProceduresFemaleHumansInfantInfant, NewbornPregnancyRetrospective StudiesTreatment OutcomeUltrasonography, PrenatalFetalFontanHypoplastic Left Heart SyndromeNorwood

Identifiers

PMID37219587
OpenAlexW4377564749

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.