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Long-term evaluation of the sape of the rconstructed daphragm in ptients with left-sided congenital diaphragmatic Hernia using serial chest radiographs and correlation to further complications

Background: Defining risk factors for long-term comorbidities in patients after neonatal repair of congenital diaphragmatic hernia (CDH) is an important cornerstone of the implementation of targeted longitudinal follow-up programs. Methods: This study systematically assessed serial chest radiographs...

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Main Authors: Schrottenberg, Christoph von (Author) , Lindacker, Maren (Author) , Weis, Meike (Author) , Büttner, Sylvia (Author) , Schaible, Thomas (Author) , Boettcher, Michael (Author) , Wessel, Lucas (Author) , Zahn, Katrin (Author)
Format: Article (Journal)
Language:English
Published: 22 January 2024
In: Journal of Clinical Medicine
Year: 2024, Volume: 13, Issue: 2, Pages: 1-16
ISSN:2077-0383
DOI:10.3390/jcm13020620
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/jcm13020620
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2077-0383/13/2/620
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Author Notes:Christoph von Schrottenberg, Maren Lindacker, Meike Weis, Sylvia Büttner, Thomas Schaible, Michael Boettcher, Lucas M. Wessel and Katrin B. Zahn
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Summary:Background: Defining risk factors for long-term comorbidities in patients after neonatal repair of congenital diaphragmatic hernia (CDH) is an important cornerstone of the implementation of targeted longitudinal follow-up programs. Methods: This study systematically assessed serial chest radiographs of 89 patients with left-sided CDH throughout a mean follow-up of 8.2 years. These geometrical variables for the left and right side were recorded: diaphragmatic angle (LDA, RDA), diaphragmatic diameter (LDD, RDD), diaphragmatic height (LDH, RDH), diaphragmatic curvature index (LDCI, RDCI), lower lung diameter (LLLD, RLLD) and thoracic area (LTA, RTA). Results: It was demonstrated that the shape of the diaphragm in patients with large defects systematically differs from that of patients with small defects. Characteristically, patients with large defects present with a smaller LDCI (5.1 vs. 8.4, p < 0.001) at 6 months of age, which increases over time (11.4 vs. 7.0 at the age of 15.5 years, p = 0.727), representing a flattening of the patch and the attached rudimentary diaphragm as the child grows. Conclusions: Multiple variables during early follow-up were significantly associated with comorbidities such as recurrence, scoliotic curves of the spine and a reduced thoracic area. Some geometrical variables may serve as surrogate parameters for disease severity, which is associated with long-term comorbidities.
Item Description:Gesehen am 10.10.2024
Physical Description:Online Resource
ISSN:2077-0383
DOI:10.3390/jcm13020620

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