期刊
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
卷 36, 期 1, 页码 -出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/14767058.2023.2201654
关键词
Aortic coarctation; newborn; cardiac surgery; patent ductus arteriosus; echocardiography
This study aimed to predict the likelihood of surgical intervention for CoA in newborns with prenatal suspicion by utilizing the presence of PDA. The results showed that CoMOD > 0 had high sensitivity and specificity in predicting the need for surgical repair of CoA in neonates.
Introduction The evaluation of upcoming Aortic Coarctation (CoA) in new-borns with prenatal suspicion entails a close echocardiographic monitor until Arterial Duct (AD) closure, in a department with pediatric cardiological and surgical expertise. The significant number of false-positive prenatal diagnoses causes parental stress and healthcare costs. Aim The aim of this study was to elaborate an echocardiographic prediction model to be employed at birth when PDA is still present, in patients suspected of CoA during fetal life in order to foretell CoA requiring neonatal surgical intervention. Methods This retrospective monocentric study included consecutive full-term and late preterm neonates with prenatal suspicion of CoA born from 01 January 2007 to 31 December 2020. Patients were divided into two groups according to the need for aortic surgery (CoA - NoCoA). All patients underwent a comprehensive transthoracic echocardiographic exam in presence of PDA. Multivariable logistic regression was used to create a coarctation probability model (CoMOD) including isthmal (D4), transverse arch (D3) diameters, the distance between a left common carotid artery (LCA) and left subclavian artery (LSA), presence/absence of ventricular septal defect (VSD) and bicuspid aortic valve (BAV). Results We enrolled 87 neonates (49 male, 56%). 44 patients developed CoA in need of surgical repair. Our index CoMOD showed an AUC = 0.9382, high sensitivity (91%) and specificity (86%) in the prediction of CoA in neonates with prenatal suspicion. We classified neonates with CoMOD > 0 to be at high risk for surgical correction of CoA, with good PPV (86.9%) and NPV (90.9%). Conclusions CoMOD > 0 is highly suggestive of the need for CoA corrective surgery in newborns with prenatal suspicion.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据