{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:36:43Z","timestamp":1792435003675,"version":"4.5.0"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:p>\n            Objective\u2003Heterotaxy syndrome (HS) is often associated with complex congenital heart disease (CHD). While fetal echocardiography (FE) permits accurate prenatal identification of most CHD, the high level of disease complexity in HS may pose challenges in predicting postnatal findings and outcomes. This study aimed to define the accuracy of FE in predicting postnatal anatomy, physiology, and surgical management of CHD in the setting of HS.<\/jats:p><jats:p>\n            Study Design\u2003Retrospective single-center cohort study including all patients with a prenatal diagnosis of HS from 2003 to 2018. Anatomic diagnoses from FE reports were compared with postnatal echocardiogram, catheterization, and operative reports. Prenatal predictions were compared with postnatal outcomes with a focus on ductal dependence, time to first intervention (immediate, neonatal period, 1\u20136 months, or older than 6 months), and surgical approach (single or biventricular).<\/jats:p><jats:p>\n            Results\u2003There were 102 pregnancies with fetal HS resulting in 21 terminations, 5 fetal losses, and 76 live births. Of the live births, 55 had significant CHD and available postnatal data for review. Among this group, survival to 1 year was 62% and was no different comparing single versus biventricular surgical approach. FE diagnostic accuracy varied by anatomic feature and was the lowest for diagnosis of venous anatomy. Determination of postnatal care was most accurate for predicting single versus biventricular surgical approach (91%), followed by ductal dependence (75%). Accuracy for predicting time to first intervention was the lowest at 69%. The most common reason for an incorrect prediction was difficulty in assessing the severity of pulmonary stenosis.<\/jats:p><jats:p>\n            Conclusion\u2003FE permits accurate predictions regarding surgical approach. Characterizing systemic and pulmonary veins is challenging, as is predicting ductal dependence and time to first intervention. These data suggest that despite the high diagnostic accuracy of CHD in HS, a circumspect approach may be reasonable with regard to predicting some anatomic details and postnatal management decisions.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1732457","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:34:33Z","timestamp":1626741273000},"page":"1081-1087","source":"Crossref","is-referenced-by-count":5,"title":["Predicting Cardiac Anatomy, Physiology, and Surgical Management Based on Fetal Echocardiography in Heterotaxy Syndrome"],"prefix":"10.1055","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8597-2690","authenticated-orcid":false,"given":"Jennifer","family":"Romanowicz","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Children's National Hospital, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranava","family":"Sinha","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Children's National Hospital, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary T.","family":"Donofrio","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Children's National Hospital, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David N.","family":"Schidlow","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,7,19]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1002\/uog.14871","article-title":"Extracardiac anomalies in prenatally diagnosed heterotaxy syndrome","volume":"47","author":"I Gottschalk","year":"2016","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1002\/uog.17546","article-title":"Outcome of prenatally diagnosed fetal heterotaxy: systematic review and meta-analysis","volume":"51","author":"D IP Buca","year":"2018","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/j.amjcard.2005.09.119","article-title":"Spectrum of cardiovascular disease, accuracy of diagnosis, and outcome in fetal heterotaxy syndrome","volume":"97","author":"M Taketazu","year":"2006","journal-title":"Am J Cardiol"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.amjcard.2014.05.042","article-title":"Perinatal and infant outcomes of prenatal diagnosis of heterotaxy syndrome (asplenia and polysplenia)","volume":"114","author":"M C 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