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Article ; Online: Correction to: Scientific Abstracts from the Phoenix Children's 13th Annual Fetal Cardiology Symposium December 8-11, 2022 at The Phoenician, Scottsdale, AZ.

Lindblade, Christopher

2023 Volume 44, Issue Suppl 1, Page(s) 6

Language	English
Publishing date	2023-05-08
Publishing country	United States
Document type	Published Erratum
ZDB-ID	800857-7
ISSN	1432-1971 ; 0172-0643
ISSN (online)	1432-1971
ISSN	0172-0643
DOI	10.1007/s00246-023-03169-y
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Zs.A 1528: Show issues

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Article ; Online: The Pandemic Effect: Did Limited Access to Care during the COVID-19 Pandemic Affect Newborns with Single-Ventricle Congenital Heart Disease?

Maenchen, Molly / Lindblade, Christopher / Bhat, Deepti P

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography

2023 Volume 36, Issue 5, Page(s) 557–558

MeSH term(s)	Humans ; Infant, Newborn ; COVID-19 ; Pandemics ; Heart Defects, Congenital/epidemiology ; Heart Defects, Congenital/surgery ; SARS-CoV-2 ; Health Services Accessibility
Language	English
Publishing date	2023-02-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	1035622-8
ISSN	1097-6795 ; 0894-7317
ISSN (online)	1097-6795
ISSN	0894-7317
DOI	10.1016/j.echo.2023.02.002
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Zs.A 2638: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Isolated Right Subclavian Artery From the Pulmonary Artery in D-Transposition of the Great Arteries.

Hamilton, Tiffany R / Sabati, Arash A / Nowlen, Todd T / Ellsworth, Erik G / Lindblade, Christopher L

CASE (Philadelphia, Pa.)

2023 Volume 7, Issue 4, Page(s) 134–137

Language	English
Publishing date	2023-02-20
Publishing country	United States
Document type	Case Reports
ISSN	2468-6441
ISSN (online)	2468-6441
DOI	10.1016/j.case.2022.12.009
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Article ; Online: Prenatal detection of congenital heart disease: Recent experience across the state of Arizona.

Mattia, Donald / Matney, Chelsea / Loeb, Sophie / Neale, Morgan / Lindblade, Christopher / Scheller McLaughlin, Ericka / Rao, Rashmi

Prenatal diagnosis

2023 Volume 43, Issue 9, Page(s) 1166–1175

Abstract: Objective: To determine the prenatal detection rate (PDR) of congenital heart disease (CHD) in Arizona as well as describe various factors that may influence detection rates.: Methods: This was a retrospective chart review using the Society of ... ...

Abstract	Objective: To determine the prenatal detection rate (PDR) of congenital heart disease (CHD) in Arizona as well as describe various factors that may influence detection rates. Methods: This was a retrospective chart review using the Society of Thoracic Surgeons and Phoenix Children's Fetal Cardiology databases. We included all cases of CHD requiring surgery <1 year of age between 2013 and 2018. A total of 1137 patients met the criteria, and various demographic, socioeconomic, and patient outcome data were collected. Results: The overall PDR was 58% with an improving detection rate over the course of our study, with the final year having a PDR of 67%. Over time, PDR improved in urban communities, but this was not seen in rural communities. Rural address, public insurance, and Native American ethnicity were associated with lower PDR. Postnatal outcomes, including Apgars, initial pH, and lactate, did not differ with the presence of a prenatal diagnosis. Diagnoses typically identified with the outflow tract and 3-vessel views on the fetal echocardiogram were less likely to be detected prenatally. Conclusions: The PDR of CHD continues to improve with evolving technologies and guidelines. We highlight a discrepancy between urban, rural, and Native American populations. Additionally, by supplying descriptors of missed diagnosis and associated echocardiography views, we hope to provide data for future interventions.
MeSH term(s)	Pregnancy ; Child ; Female ; Humans ; Retrospective Studies ; Arizona/epidemiology ; Ultrasonography, Prenatal ; Heart Defects, Congenital/diagnostic imaging ; Heart Defects, Congenital/surgery ; Fetal Heart/diagnostic imaging
Language	English
Publishing date	2023-07-25
Publishing country	England
Document type	Journal Article
ZDB-ID	82031-3
ISSN	1097-0223 ; 0197-3851
ISSN (online)	1097-0223
ISSN	0197-3851
DOI	10.1002/pd.6409
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Zs.A 1625: Show issues

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Article: Novel Case of Prader–Willi Syndrome and Ebstein's Anomaly: Implications for Complex Care Management

Mattia, Donald / Lindblade, Christopher / Oatman, Oliver / Prakash, Supraja / Grebe, Theresa

Journal of Pediatric Genetics

2022

Abstract: We present a patient with a complex phenotype including diagnoses of Ebstein's anomaly and Prader–Willi syndrome (PWS) as well as additional congenital anomalies and genetic variants with potential clinical effects. This is the first reported case of ... ...

Abstract	We present a patient with a complex phenotype including diagnoses of Ebstein's anomaly and Prader–Willi syndrome (PWS) as well as additional congenital anomalies and genetic variants with potential clinical effects. This is the first reported case of both diagnoses present in the same patient. The diagnosis of Ebstein's anomaly was made on prenatal ultrasound. She presented with neonatal hypotonia, feeding problems, and dysmorphic features, followed by later onset weight gain, leading to a diagnosis of PWS. Further evaluations revealed Blaschkoid hyperpigmentation, laryngeal cleft, and pigmentary retinopathy. Whole exome sequencing determined a likely pathogenic variant in alkaline phosphatase gene and several mitochondrial DNA variants. We discuss the known genetic mechanisms of PWS and compare them to the heterogenous genetic associations of Ebstein's anomaly. The standard of care treatment for PWS is growth hormone therapy, which is associated with right-sided heart failure risks. This case illustrates the need to complete the diagnostic work up in all patients, as well as the necessity of a multidisciplinary approach for optimal outcomes.
Keywords	Prader–Willi ; Ebstein's anomaly ; Growth hormone ; Blaschkoid hyperpigmentation
Language	English
Publishing date	2022-10-10
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ISSN	2146-460X ; 2146-4596
ISSN (online)	2146-460X
ISSN	2146-4596
DOI	10.1055/s-0042-1757449
Database	Thieme publisher's database

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Article ; Online: Four-dimensional fetal cardiac imaging in a cohort of fetuses with suspected congenital heart disease.

Rubert, Nicholas C / Jategaonkar, Gaurav / Plasencia, Jonathan D / Lindblade, Christopher L / Bardo, Dianna M E / Goncalves, Luis F

Pediatric radiology

2022 Volume 53, Issue 2, Page(s) 198–209

Abstract: Background: Fetal cardiac magnetic resonance imaging (MRI) requires high spatial and temporal resolution and robustness to random fetal motion to capture the dynamics of the beating fetal heart. Slice-to-volume reconstruction techniques can produce high- ...

Abstract	Background: Fetal cardiac magnetic resonance imaging (MRI) requires high spatial and temporal resolution and robustness to random fetal motion to capture the dynamics of the beating fetal heart. Slice-to-volume reconstruction techniques can produce high-resolution isotropic images while compensating for random fetal motion. Objective: The objective of this study was to evaluate image quality for slice-to-volume reconstruction of four-dimensional balanced steady-state free precession (bSSFP) imaging of the fetal heart. Materials and methods: A cohort of 13 women carrying fetuses with congenital heart disease were imaged with real-time bSSFP sequences. Real-time bSSFP sequences were post-processed using a slice-to-volume reconstruction algorithm to produce retrospectively gated 4-D sequences with isotropic spatial resolution. Two radiologists evaluated slice-to-volume reconstruction image quality on a scale from 0 to 4 using 11 categories based on a segmental approach to defining cardiac anatomy and pathology. A score of 0 corresponded to cardiac structures not visualized at all and four corresponded to high quality and distinct appearance of structures. Results: In 11 out of 13 cases, the average radiologist score of image quality across all categories was 3.0 or greater. In the remaining two cases, slice-to-volume reconstruction was not possible due to insufficient image quality in the acquisition. Conclusion: Slice-to-volume reconstruction has the potential to produce isotropic images with high spatial and temporal resolution that can display the anatomy of the fetal heart in arbitrary imaging planes retrospectively. More rapid, motion-robust acquisitions may be necessary to successfully reconstruct the fetal heart in all patients.
MeSH term(s)	Humans ; Female ; Retrospective Studies ; Image Interpretation, Computer-Assisted/methods ; Heart ; Heart Defects, Congenital/diagnostic imaging ; Magnetic Resonance Imaging/methods ; Fetus ; Fetal Heart/diagnostic imaging ; Fetal Heart/pathology
Language	English
Publishing date	2022-10-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	124459-0
ISSN	1432-1998 ; 0301-0449
ISSN (online)	1432-1998
ISSN	0301-0449
DOI	10.1007/s00247-022-05500-w
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Article ; Online: Contribution of fetal magnetic resonance imaging in fetuses with congenital heart disease.

Goncalves, Luis F / Lindblade, Christopher L / Cornejo, Patricia / Patel, Mittun C / McLaughlin, Ericka Scheller / Bardo, Dianna M E

Pediatric radiology

2021 Volume 52, Issue 3, Page(s) 513–526

Abstract: Background: Increasing evidence supports an association among congenital heart disease (CHD), structural brain lesions on neuroimaging, and increased risk of neurodevelopmental delay and other structural anomalies. Fetal MRI has been found to be ... ...

Abstract	Background: Increasing evidence supports an association among congenital heart disease (CHD), structural brain lesions on neuroimaging, and increased risk of neurodevelopmental delay and other structural anomalies. Fetal MRI has been found to be effective in demonstrating fetal structural and developmental abnormalities. Objective: To determine the contribution of fetal MRI to identifying cardiovascular and non-cardiovascular anomalies in fetuses with CHD compared to prenatal US and fetal echocardiography. Materials and methods: We performed a retrospective study of fetuses with CHD identified by fetal echocardiography. Exams were performed on 1.5-tesla (T) or 3-T magnets using a balanced turbo field echo sequence triggered by an external electrocardiogram simulator with a fixed heart rate of 140 beats per minute (bpm). Fetal echocardiography was performed by pediatric cardiologists and detailed obstetrical US by maternal-fetal medicine specialists prior to referral to MRI. We compared the sensitivity of fetal MRI and fetal echocardiography for the diagnosis of cardiovascular anomalies, as well as the sensitivity of fetal MRI and referral US for the diagnosis of non-cardiac anomalies. We performed statistical analysis using the McNemar test. Results: We identified 121 anomalies in 31 fetuses. Of these, 73 (60.3%) were cardiovascular and 48 (39.7%) involved other organ systems. Fetal echocardiography was more sensitive for diagnosing cardiovascular anomalies compared to fetal MRI, but the difference was not statistically significant (85.9%, 95% confidence interval [CI] 77.8-94.0% vs. 77.5%, 95% CI 67.7-87.2%, respectively; McNemar test 2.29; P=0.13). The sensitivity of fetal MRI was higher for diagnosing extracardiac anomalies when compared to referral US (84.1%, 95% CI 73.3-94.9% vs. 31.8%, 95% CI 18.1-45.6%, respectively; McNemar test 12.9; P<0.001). The additional information provided by fetal MRI changed prognosis, counseling or management for 10/31 fetuses (32.2%), all in the group of 19 fetuses with anomalies in other organs and systems besides CHD. Conclusion: Fetal MRI performed in a population of fetuses with CHD provided additional information that altered prognosis, counseling or management in approximately one-third of the fetuses, mainly by identifying previously unknown anomalies in other organs and systems.
MeSH term(s)	Child ; Female ; Fetal Heart ; Fetus/diagnostic imaging ; Heart Defects, Congenital/diagnostic imaging ; Humans ; Magnetic Resonance Imaging/methods ; Pregnancy ; Prenatal Diagnosis/methods ; Retrospective Studies ; Ultrasonography, Prenatal/methods
Language	English
Publishing date	2021-11-29
Publishing country	Germany
Document type	Journal Article
ZDB-ID	124459-0
ISSN	1432-1998 ; 0301-0449
ISSN (online)	1432-1998
ISSN	0301-0449
DOI	10.1007/s00247-021-05234-1
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Article ; Online: Telehealth multidisciplinary prenatal consultation during the COVID-19 pandemic: enhancing patient care coordination while maintaining high provider satisfaction.

Hargis-Villanueva, Angela / Lai, Krista / van Leeuwen, Kathleen / Weidler, Erica M / Felts, Jessica / Schmidt, Alicia / Franklin, Wayne J / Lindblade, Christopher / Martin, Gregory C / Patil, Avinash S / Goncalves, Luis F

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

2022 Volume 35, Issue 25, Page(s) 9765–9769

Abstract: Objective: Comprehensive fetal care centers address congenital anomalies by developing pre- and post-natal care plans in a multidisciplinary format. To reduce exposure during the Coronavirus Infectious Disease-2019 (COVID-19) pandemic, the Centers for ... ...

Abstract	Objective: Comprehensive fetal care centers address congenital anomalies by developing pre- and post-natal care plans in a multidisciplinary format. To reduce exposure during the Coronavirus Infectious Disease-2019 (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) broadened access to telehealth services. We assessed provider satisfaction with the rapid transition from in-person prenatal visits to multidisciplinary consultations Methods: Patients referred to an urban academic fetal care center during the first 6 weeks of the COVID-19 pandemic underwent advanced imaging including fetal MRI, focused ultrasound, and fetal echocardiography. Subsequently, multidisciplinary telehealth consultations occurred with all providers attending virtually. Patients were given the option of attending the multidisciplinary telehealth consultation in a conference room in the hospital or from home. During these meetings, relevant images were reviewed with all participants Results: Twenty-two surveys were administered with a response rate of 82%. 89% of providers were highly satisfied with the telehealth format. 72% of providers would prefer the multidisciplinary telehealth format to an in-person visit for future visits after COVID-19 restrictions are lifted. 22% of providers would leave the choice to the patient's family. One provider preferred in-person visits. Some providers noted that virtual conferences limited the ability to draw pictures, show educational materials, and provide emotional support. Conclusion: Providers were overwhelmingly supportive of continuing multidisciplinary telehealth conferences for complex prenatal consultations, even after restrictions are lifted, which has led to the continuation of this model for the duration of the pandemic. Providers highlighted the convenience and improved care coordination across specialties. Further studies to examine the patient experience with virtual consultations are warranted.
MeSH term(s)	Aged ; Pregnancy ; Female ; Humans ; United States ; Pandemics ; COVID-19 ; Personal Satisfaction ; Patient Satisfaction ; Medicare ; Telemedicine/methods ; Prenatal Care/methods ; Referral and Consultation ; Communicable Diseases
Language	English
Publishing date	2022-03-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2077261-0
ISSN	1476-4954 ; 1057-0802 ; 1476-7058
ISSN (online)	1476-4954
ISSN	1057-0802 ; 1476-7058
DOI	10.1080/14767058.2022.2053101
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Article ; Online: Reducing the burden of surveillance in pregnant women with no history of fetal atrioventricular block using the negative predictive value of anti-Ro/SSA antibody titers.

Kaizer, Alexander M / Lindblade, Christopher / Clancy, Robert / Tebo, Anne E / Drewes, Bailey / Masson, Mala / Chang, Miao / Fraser, Nicola / Buyon, Jill P / Cuneo, Bettina F

American journal of obstetrics and gynecology

2022 Volume 227, Issue 5, Page(s) 761.e1–761.e10

Abstract: Background: The risk of fetal atrioventricular block in anti-Ro/SSA antibody-exposed pregnancies with no previous affected offspring is approximately 2%. A high antibody titer is necessary but not sufficient for atrioventricular block, and specific ... ...

Abstract	Background: The risk of fetal atrioventricular block in anti-Ro/SSA antibody-exposed pregnancies with no previous affected offspring is approximately 2%. A high antibody titer is necessary but not sufficient for atrioventricular block, and specific antibody titers do not predict risk. However, there are no data on the negative predictive value of antibody titer to identify pregnancies at low risk of fetal atrioventricular block, and may not require surveillance. Objective: This study aimed to define anti-Ro52 and anti-Ro60 antibody thresholds for the identification of fetuses unlikely to develop atrioventricular block using clinically validated and research laboratory tests. Study design: This study performed a multicenter review of pregnant subjects who tested positive in their local commercial laboratories for anti-Ro/SSA antibodies at the University of Colorado Children's Hospital (2014-2021) and Phoenix Children's Hospital (2014-2021) and enrolled in the Research Registry for Neonatal Lupus (RRNL) at New York University Langone Medical Center (2002-2021). The subjects were referred on the basis of rheumatologic symptoms or history of atrioventricular block in a previous pregnancy and were retrospectively grouped on the basis of pregnancy outcome. Group 1 indicated no fetal atrioventricular block in current or past pregnancies; group 2 indicated fetal atrioventricular block in the current pregnancy; and group 3 indicated normal current pregnancy but with fetal atrioventricular block in a previous pregnancy. Maternal sera were analyzed for anti-Ro52 and anti-Ro60 antibodies using a clinically validated multiplex bead assay (Associated Regional and University Pathologists Laboratories, Salt Lake City, UT) and a research enzyme-linked immunosorbent immunoassay (New York University). This study calculated the negative predictive value separately for anti-Ro52 and anti-Ro60 antibodies and for the 2 combined using a logistic regression model and a parallel testing strategy. Results: This study recruited 270 subjects (141 in group 1, 66 in group 2, and 63 in group 3). Of note, 89 subjects in group 1 had data on hydroxychloroquine treatment: anti-Ro/SSA antibody titers were no different between those treated (n=46) and untreated (n=43). Mean anti-Ro52 and anti-Ro60 titers were the lowest in group 1 and not different between groups 2 and 3. No case of fetal atrioventricular block developed among subjects with anti-Ro52 and anti-Ro60 titers of <110 arbitrary units per milliliter using the multiplex bead assay of the Associated Regional and University Pathologists Laboratories (n=141). No case of fetal atrioventricular block developed among subjects with research laboratory anti-Ro52 titers of <650 and anti-Ro60 of <4060 enzyme-linked immunosorbent immunoassay units (n=94). Using these 100% negative predictive value thresholds, more than 50% of the anti-Ro/SSA antibody pregnancies that ultimately had no fetal atrioventricular block could be excluded from surveillance based on clinical and research titers, respectively. Conclusion: Study data suggested that there is a clinical immunoassay level of maternal anti-Ro/SSA antibodies below which the pregnancy is at low risk of fetal atrioventricular block. This study speculated that prospectively applying these data may avert the costly serial echocardiograms currently recommended for all anti-Ro/SSA-antibody positive pregnancies and guide future management.
MeSH term(s)	Child ; Infant, Newborn ; Pregnancy ; Female ; Humans ; Atrioventricular Block ; Pregnant Women ; Retrospective Studies ; Immunosorbents ; Predictive Value of Tests ; Antibodies, Antinuclear ; Pregnancy Outcome ; Fetus ; Lupus Erythematosus, Systemic
Chemical Substances	Immunosorbents ; Antibodies, Antinuclear
Language	English
Publishing date	2022-06-08
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ZDB-ID	80016-8
ISSN	1097-6868 ; 0002-9378
ISSN (online)	1097-6868
ISSN	0002-9378
DOI	10.1016/j.ajog.2022.05.071
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Article ; Online: Congenitally Corrected Transposition of the Great Arteries: Fetal Diagnosis, Associations, and Postnatal Outcome: A Fetal Heart Society Research Collaborative Study.

Journal of the American Heart Association

2023 Volume 12, Issue 11, Page(s) e029706

Abstract: Background Fetal diagnosis of congenitally corrected transposition of the great arteries (ccTGA) has been increasingly reported; however, predictors of clinical outcomes remain underexplored. We undertook a multicenter, retrospective study to investigate ...

Abstract	Background Fetal diagnosis of congenitally corrected transposition of the great arteries (ccTGA) has been increasingly reported; however, predictors of clinical outcomes remain underexplored. We undertook a multicenter, retrospective study to investigate natural history, associated anomalies, and outcomes of fetal ccTGA. Methods and Results Fetuses with ccTGA diagnosed from January 2004 to July 2020 within 20 North American programs were included. Fetuses with severe ventricular hypoplasia thought to definitively preclude biventricular repair were excluded. We included 205 fetuses diagnosed with ccTGA at a median gestational age of 23 (interquartile range, 21-27) weeks. Genetic abnormalities were found in 5.9% tested, with extracardiac anomalies in 6.3%. Associated cardiac defects were diagnosed in 161 (78.5%), with atrioventricular block in 23 (11.3%). On serial fetal echocardiogram, 39% demonstrated a functional or anatomic change, most commonly increased tricuspid regurgitation (6.7%) or pulmonary outflow obstruction (11.1%). Of 194 fetuses with follow-up, 26 were terminated, 3 experienced fetal death (2 with atrioventricular block), and 165 were live-born. Of 158 with postnatal data (median follow-up 3.7 years), 10 (6.6%) had death/transplant before 1 year. On univariable analysis, fetal factors associated with fetal death or death/transplant by 1 year included ≥ mild tricuspid regurgitation, pulmonary atresia, aortic obstruction, fetal arrhythmia, and worsening hemodynamics on serial fetal echocardiogram (defined as worse right ventricular function, tricuspid regurgitation, or effusion). Conclusions Associated cardiac lesions and arrhythmias are common in fetal ccTGA, and functional changes commonly occur through gestation. Worse outcomes are associated with fetal tricuspid regurgitation (≥mild), any arrhythmia, pulmonary atresia, aortic obstruction, and worsening hemodynamics on serial echocardiograms. These findings can inform prenatal counseling and perinatal management planning.
MeSH term(s)	Female ; Humans ; Pregnancy ; Infant ; Congenitally Corrected Transposition of the Great Arteries ; Transposition of Great Vessels/diagnostic imaging ; Transposition of Great Vessels/surgery ; Transposition of Great Vessels/complications ; Tricuspid Valve Insufficiency/complications ; Atrioventricular Block/complications ; Retrospective Studies ; Follow-Up Studies ; Prenatal Diagnosis ; Heart Defects, Congenital/diagnostic imaging ; Heart Defects, Congenital/surgery ; Heart Defects, Congenital/complications ; Fetal Heart/diagnostic imaging ; Fetal Heart/pathology ; Arrhythmias, Cardiac/complications ; Pulmonary Atresia ; Fetal Death
Language	English
Publishing date	2023-06-01
Publishing country	England
Document type	Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.122.029706
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