World Journal for Pediatric and Congenital Heart Surgery
2019, Vol. 10(6) 702-706
Submitted June 27, 2019; Accepted August 13, 2019.
ãThe Author(s) 2019
Detecting Critical Congenital Heart Disease in Nevada
William N. Evans, MD, Ruben J. Acherman, MD, Michael L. Ciccolo, MD, Juan M. Lehoux, MD, Abraham Rothman, MD, Alvaro Galindo, MD
William N. Evans, Children’s Heart Center Nevada, 3006 S. Maryland Pkwy,
Ste. 690, Las Vegas, NV 89109, USA.
Background: We reviewed data on patients born with critical congenital heart disease in the state of Nevada and analyzed
detection via prenatal diagnosis versus newborn pulse oximetry screening, location of birth, and gestational age at birth.
Methods: We inquired our databases and electronic health records for all patients with critical congenital heart disease born in
Nevada between January 2016 and May 2019. Results: We identified 218 live born patients. Of the 218, average gestational age
was 38 weeks (+2.2 weeks). Of the 218, 171 (78%) were prenatally diagnosed, 37 (17%) were diagnosed by immediate postnatal
signs and symptoms, 8 (4%) had false-negative pulse oximetry screens that resulted in post-hospital discharge presentations, and 2
(1%) had positive pulse oximetry screens. The eight post-hospital discharge presentations included four in extremis, two with
extreme cyanosis, and two dying at home. Of the 171 prenatally diagnosed patients, 157 (92%) were born at the Nevada hospital
with the congenital cardiac unit. Conclusion: To the best of our knowledge, our results represent the highest statewide, general
population prenatal detection of critical congenital heart disease in the United States. Our high prenatal detection rate led to the
majority of patients being born at the Nevada facility with the congenital heart unit, limiting intrastate neonatal transports. On
average, patients were born at term. Further, in Nevada, state-mandated, universal pulse oximetry screening resulted in more
false-negative results than positive results.