Table 1.
1. Dominant cardiac anatomic anomaly is valvar AS with all of the following |
Decreased mobility of valve leaflets |
Antegrade Doppler color flow jet across aortic valve smaller than the valve annulus diameter |
No or minimal subvalvar LV outflow obstruction |
2. Evolving HLHS |
LV function qualitatively depressed AND EITHER Retrograde or bidirectional flow in the transverse aortic arch (between the first 2 brachiocephalic vessels) at any time during the cardiac cycle OR two of the following: Monophasic MV inflow (Doppler profile of MV inflow without discrete E and A waves) Left-to-right flow across atrial septum or intact atrial septum (bulging left to right) Bidirectional flow in pulmonary veins |
3. Potential for a technically successful procedure and biventricular outcome postnatally |
Criteria used for most of the patients in the present study (all 3 of the following) |
LV long-axis Z score ≥−2 |
LV function qualitatively depressed but generating at least a 10 mm Hg pressure gradient across aortic valve or 15 mm Hg MR jet gradient |
MV diameter Z score >−3 |
Modified criteria based on the findings of the present study |
Unequivocal AS (vs aortic atresia) |
LV long-axis Z score >−2 |
Threshold score ≥4 (≥4 of the following) |
LV long-axis Z score >0 |
LV short-axis Z score >0 |
Aortic annulus Z score >−3.5 |
MV annulus Z score >−2 |
MR or AS maximum systolic gradient ≥20 mm Hg |