Cardiac performance and left ventricular dimensions in neonates with left-sided congenital diaphragmatic hernia before and after surgical repair
Abstract
Background: Congenital Diaphragmatic Hernia (CDH) is associated with significant cardiopulmonary morbidity. Pulmonary Hypertension (PH) and left ventricular (LV) dysfunction are major determinants of outcome. While the impact of CDH repair on pulmonary hemodynamics is recognized, comprehensive serial assessment of cardiac performance, specifically LV dimensions and function, surrounding surgical repair is limited.
Objectives: To characterize changes in LV dimensions, systolic/diastolic function, and global cardiac performance in neonates with CDH immediately before and within 48-72 h after surgical repair.
Methods: A prospective observational cohort study conducted between January 2022 and January 2025 in our tertiary center. Term neonates with isolated, left-sided Bochdalek CDH requiring surgical repair were included. Comprehensive transthoracic echocardiography (TTE) was performed at three time points: (1) Pre-Operative (Pre-Op): Within 24 h before repair (after initial stabilization), (2) Early Post-Operative (E-Post-Op): 48-72 h after completion of surgical repair. (3) One-month Post-Operative (M-Post-Op): One month after completion of surgical repair. Parameters measured from the LV and from the right ventricle (RV), Ventilator settings, inotrope score, and vasoactive-inotrope score (VIS) were recorded concurrently. Data were recorded and analyzed.
Results: Thirty neonates met the inclusion criteria (Median gestational age: 38 weeks [IQR 37-39], Birth weight: 3.0kg [IQR…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 21 participants or records.
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