Programa del congreso
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Mi-P1: Sesión de pósteres I Lugar: Zona pósteres P1: Sesión de pósteres I | |
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Enhancing Prenatal Aortic Coarctation Detection 1: Universitat Pompeu Fabra, Spain; 2: BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine, Spain; 3: August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain; 4: ICREA - Catalan Institution for Research and Advanced Studies, Spain Aortic coarctation (CoA) is a congenital heart disease involving narrowing of the aortic isthmus or arch, representing 6–8% of infant CHD cases. Prenatal detection often relies on nonspecific signs such as cardiac asymmetry with right ventricular dominance, leading to high false-positive rates, with approximately 60% of true cases missed and only 20–35% of prenatal diagnoses confirmed postnatally. Advances in prenatal screening have improved CoA detection, enabling earlier intervention. Emerging scoring systems and diagnostic models show promise but remain underused in daily clinical practice. By assessing their performance in a new population and incorporating them into a web-based tool, we aim to determine the most effective approaches and facilitate their routine use in CoA diagnosis. Retrospective clinical data of 172 patients collected from Hospital Clínic and Hospital Sant Joan de Déu (2010-2023) was considered. With an n = 75/175 of high prenatal risk of CoA, 71 cases were postnatally diagnosed, while 85 were categorized as healthy despite low-risk prenatal suspicions, based on indicators as right-side dominance. An experienced observer used BCNMedTech’s TransCOR platform to obtain literature-based fetal valve and artery measurements, which were then applied to replicate risk models from Gómez-Montes et al, Freeman et al, Deiros-Bronte et al and Fricke et al. The findings indicate moderate performance across calculators in the population, with a mean sensibility value of 0.833, specificity of 0.691 and AUC of 0.83, suggesting room for further optimization. While the selected calculators use different aortic measurement strategies, none shows a clear overall advantage, with the model by Fricke et al. performing best in this population.These findings highlight the need for standardized criteria in measurement and parameter selection to improve early risk assessment. These results enhance the clinical utility of the developed CoA risk assessment tool, which summarizes the calculators' results longitudinally by patient and imputes missing measurements through BCN MedTech Rocket integration. The wide range of calculators and variable parameter performance in new populations highlight the need for standardized criteria, optimized selection, and simplified tools for early risk assessment of aortic coarctation. | |