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Management of prenatally detected vascular rings: a United Kingdom national survey

Published online by Cambridge University Press:  15 August 2022

Trisha V. Vigneswaran Open the ORCID record for Trisha V. Vigneswaran [Opens in a new window] ,
Lindsey E. Hunter ,
Julene S. Carvalho Open the ORCID record for Julene S. Carvalho [Opens in a new window]  and
Anna N. Seale
Trisha V. Vigneswaran*
Affiliation:
Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s & St. Thomas’ NHS Trust, London SE1 7EH, UK
Lindsey E. Hunter
Affiliation:
Department of Paediatric Cardiology, Royal Hospital for Children, Glasgow, UK
Julene S. Carvalho
Affiliation:
Brompton Centre for Fetal Cardiology, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK Fetal Medicine Unit, St. George’s University Hospitals NHS Foundation Trust, London, UK Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St. George’s University of London, London, UK
Anna N. Seale
Affiliation:
Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK Heart Unit, Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK
*
Author for correspondence: Dr Trisha V. Vigneswaran MBBS BSc(Hons.) MD(res) MRCPCH, Department of Congenital Heart Disease, Evelina London Children’s Hospital, Guy’s & St Thomas’ NHS Trust, London SE1 7EH, UK. E-mail: Trisha.vigneswaran@gstt.nhs.uk
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Abstract

Objective:

To investigate UK variability in prenatal and postnatal management strategy of right aortic arch and double aortic arch (RAA/DAA).

Methods:

Online surveys were sent to senior physicians (consultants) of the National Fetal Cardiology Working Group regarding prenatal diagnosis, counselling, and perinatal management of antenatally diagnosed RAA/DAA and to the British Congenital Cardiovascular Association regarding postnatal management strategies.

Results:

There were 28 prenatal and 90 postnatal surveys completed. Prenatally, there was consensus for potential associated chromosomal/genetic anomalies, but there was variation in the risk quoted. Confidence in defining aortic arch morphology was reported by 43% (12/28) of fetal cardiologists. There was variation in what was felt to be possible symptoms/signs of a compressive vascular ring, postnatal investigation, postnatal management, follow-up duration of asymptomatic patients, and indications for surgical intervention.

Conclusion:

This study has highlighted important areas for future research: improving accuracy of prenatal diagnosis, clarification of potential symptoms, optimal investigation strategies, and indications for surgery.

Keywords

Congenital heart diseaseVascular ringPrenatal diagnosis

Information

Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 8 , August 2023 , pp. 1332 - 1335
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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