{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:54:56Z","timestamp":1787500496061,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine which echocardiographic features of hypoplastic left heart complex (HLHC) in the fetal period are predictive of biventricular (BV) circulation and to evaluate the long\u2010term outcome of patients with HLHC, including rates of mortality, reintervention and development of further cardiac disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Echocardiograms of fetuses with HLHC obtained at 18\u201326\u2009weeks and 27\u201336\u2009weeks' gestation between 2004 and 2017 were included in the analysis. The primary outcome was successful BV circulation (Group 1). Group 2 included patients with single\u2010ventricle palliation, death or transplant. Univariate analysis was performed on data obtained at 18\u201326 and 27\u201336\u2009weeks and multivariate logistic regression was performed on data obtained at 27\u201336\u2009weeks only.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 51 included cases, 44 achieved successful BV circulation (Group 1) and seven did not (Group\u00a02). Right\u2010to\u2010left\/bidirectional foramen ovale (FO) flow and a higher mitral valve (MV) annulus\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score were associated with successful BV circulation on both univariate and multivariate analysis. Bidirectional or left\u2010to\u2010right FO flow, left ventricular length (LVL)\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score of &lt;\u2009\u20132.4 and a MV\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score of &lt;\u2009\u20134.5 correctly predicted 80% of Group 2 cases. Late follow\u2010up was available for 41 patients. There were two late deaths in Group 2. Thirteen patients in Group 1 required reintervention, 12 developed mitral stenosis and five developed isolated subaortic stenosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      BV circulation is common in fetuses with HLHC. Higher MV annulus and LVL\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010scores and right to left direction of FO flow are important predictors of BV circulation. Long\u2010term sequelae in those with BV circulation may include mitral and subaortic stenosis. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.23558","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T09:34:33Z","timestamp":1606988073000},"page":"405-410","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Fetal echocardiographic predictors of biventricular circulation in hypoplastic left heart complex"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5108-1590","authenticated-orcid":false,"given":"K.","family":"Haberer","sequence":"first","affiliation":[{"name":"Fetal &amp; Neonatal Cardiology Program Division of Cardiology, Department of Pediatrics, Stollery Children's Hospital  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Fruitman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Cardiology, Alberta Children's Hospital University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Power","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Cardiology, Alberta Children's Hospital University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. K.","family":"Hornberger","sequence":"additional","affiliation":[{"name":"Fetal &amp; Neonatal Cardiology Program Division of Cardiology, Department of Pediatrics, Stollery Children's Hospital  Edmonton Alberta Canada"},{"name":"Department of Obstetrics &amp; Gynecology Lois Hole Women's Hospital, Royal Alexandra Hospital  Edmonton Alberta Canada"},{"name":"Women's &amp; Children's Health Research Institute University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Eckersley","sequence":"additional","affiliation":[{"name":"Fetal &amp; Neonatal Cardiology Program Division of Cardiology, Department of Pediatrics, Stollery Children's Hospital  Edmonton Alberta Canada"},{"name":"Women's &amp; Children's Health Research Institute University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2001.111207"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.02.020"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951115002267"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.588194"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.84.6.2325"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2597"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8831"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951112000467"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-019-02155-7"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951114001449"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(99)00621-9"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(99)70144-3"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-014-1009-0"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc3101.093904"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951114001802"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15846"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000489123"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7483"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2016.08.019"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.23558","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.23558","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.23558","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T15:33:04Z","timestamp":1747927984000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.23558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1002\/uog.23558"],"URL":"https:\/\/doi.org\/10.1002\/uog.23558","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9]]},"assertion":[{"value":"2020-07-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}