TY - JOUR
T1 - Interventions and neonatal outcomes of fetuses with hypoplastic left heart syndrome and congenital diaphragmatic hernia
T2 - a systematic review
AU - Kanade, Rahul
AU - Shazly, Sherif
AU - Ruano, Rodrigo
N1 - Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
N2 - Objective: To evaluate the current interventions and outcomes in neonates born with hypoplastic left heart syndrome (HLHS) and congenital diaphragmatic hernias (CDHs). Methods: A comprehensive search of the literature using relevant search words was conducted from the date of each database inception to August 2018 to identify interventions and outcomes in patients with CDH and HLHS. Conference papers, review articles, case reports, and animal studies were not eligible for this review. Articles were also excluded if left heart hypoplasia, rather than HLHS, was studied. Neither language nor sample size was used for exclusion. A preliminary screening of article titles was performed to rule out irrelevant articles and article types by a single reviewer. A second screening circle was performed by two independent reviewers to assess remaining abstracts. Data were presented as a systematic review and were descriptively summarized. Results: Of the 162 retrieved articles, five studies were eligible for inclusion. The total number of neonates included in this systematic review was 5063. One hundred and eighteen (2.3%) presented specifically with CDH and HLHS. Overall, a total of 62 of the 118 patients underwent a surgical procedure (51%) with 36 (59%) surviving to discharge. Conclusions: Available data suggest current surgical interventions still result in a high degree of mortality. Age at which surgery occurred, pulmonary function and the use of extra-corporeal membrane oxygenation (ECMO) are potential variables that may determine and improve outcomes in these patients in the future. However, long-term outcomes and analyses of more variables are needed to determine effective treatment for this rare but often fatal comorbid congenital diagnosis.
AB - Objective: To evaluate the current interventions and outcomes in neonates born with hypoplastic left heart syndrome (HLHS) and congenital diaphragmatic hernias (CDHs). Methods: A comprehensive search of the literature using relevant search words was conducted from the date of each database inception to August 2018 to identify interventions and outcomes in patients with CDH and HLHS. Conference papers, review articles, case reports, and animal studies were not eligible for this review. Articles were also excluded if left heart hypoplasia, rather than HLHS, was studied. Neither language nor sample size was used for exclusion. A preliminary screening of article titles was performed to rule out irrelevant articles and article types by a single reviewer. A second screening circle was performed by two independent reviewers to assess remaining abstracts. Data were presented as a systematic review and were descriptively summarized. Results: Of the 162 retrieved articles, five studies were eligible for inclusion. The total number of neonates included in this systematic review was 5063. One hundred and eighteen (2.3%) presented specifically with CDH and HLHS. Overall, a total of 62 of the 118 patients underwent a surgical procedure (51%) with 36 (59%) surviving to discharge. Conclusions: Available data suggest current surgical interventions still result in a high degree of mortality. Age at which surgery occurred, pulmonary function and the use of extra-corporeal membrane oxygenation (ECMO) are potential variables that may determine and improve outcomes in these patients in the future. However, long-term outcomes and analyses of more variables are needed to determine effective treatment for this rare but often fatal comorbid congenital diagnosis.
KW - Congenital diaphragmatic hernia;
KW - fetal anomalies;
KW - fetal therapy
KW - fetal ultrasound;
KW - hypoplastic left heart syndrome;
KW - prenatal diagnosis;
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U2 - 10.1080/14767058.2020.1849091
DO - 10.1080/14767058.2020.1849091
M3 - Review article
C2 - 33207977
AN - SCOPUS:85096292536
SN - 1476-7058
VL - 35
SP - 4184
EP - 4189
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 21
ER -