Acute Maternal Hyperoxygenation for Fetal Transposition of the Great Arteries (TGA)

NCT ID: NCT03771534

Last Updated: 2024-01-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-20

Study Completion Date

2025-01-31

Brief Summary

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This prospective study will examine whether transient maternal hyperoxygenation is useful as a diagnostic test to more accurately detect TGA patients with poor vs. good neonatal intra-cardiac mixing of blood, based on the in-utero response to oxygen exposure. This study is Health Canada regulated

Detailed Description

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This is a prospective pilot study to examine whether transient maternal hyperoxygenation is useful as a diagnostic test to more accurately detect TGA patients with poor vs. good neonatal intracardiac mixing of blood, based on the in-utero response to oxygen exposure. Acute maternal oxygen administration will transiently increase the fetal oxygen levels to those reached at birth with spontaneous breathing, thus simulating conditions that will naturally occur at the time of birth. Echocardiogram and MRI will be used to examine the effects on the fetal circulation. The prenatal findings will then be compared to the neonatal presentation.

The investigators postulate that conditions that predispose newborns to acute neonatal compromise will be detectable and distinguishable prior to birth by echocardiography, MRI, or by combining the findings of both exams.

Conditions

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TGA - Transposition of Great Arteries

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Oxygen gas

10-15 L/min of oxygen by face mask for up to 45 minutes for the MRI and up to 30 minutes for the echocardiogram.

Group Type EXPERIMENTAL

Oxygen gas

Intervention Type DRUG

Brief maternal administration of 65-70% O2 via a face mask during the last trimester

Interventions

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Oxygen gas

Brief maternal administration of 65-70% O2 via a face mask during the last trimester

Intervention Type DRUG

Other Intervention Names

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Praxair

Eligibility Criteria

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Inclusion Criteria

* Fetus with simple TGA +/- small VSD
* Intention of active postnatal management after birth

Exclusion Criteria

* Fetus with complex form of TGA
* Significant fetal arrhythmia
* Major non-cardiac lesions
* Maternal contraindications for fetal MRI
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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The Hospital for Sick Children

OTHER

Sponsor Role lead

Responsible Party

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Edgar Jaeggi

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Edgar Jaeggi, MD

Role: PRINCIPAL_INVESTIGATOR

The Hospital for Sick Children, Toronto

Mike Seed, MBBS

Role: PRINCIPAL_INVESTIGATOR

The Hospital for Sick Children, Toronto

Locations

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The Hospital For Sick Children

Toronto, , Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Edgar Jaeggi, MD

Role: CONTACT

+1(416)813-7500 ext. 207466

Mike Seed, MBBS

Role: CONTACT

+1(416)813-7500

Facility Contacts

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Edgar Jaeggi, MD

Role: primary

Mike Seed, MBBS

Role: backup

References

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Sun L, Macgowan CK, Portnoy S, Sled JG, Yoo SJ, Grosse-Wortmann L, Jaeggi E, Kingdom J, Seed M. New advances in fetal cardiovascular magnetic resonance imaging for quantifying the distribution of blood flow and oxygen transport: Potential applications in fetal cardiovascular disease diagnosis and therapy. Echocardiography. 2017 Dec;34(12):1799-1803. doi: 10.1111/echo.13760.

Reference Type BACKGROUND
PMID: 29287129 (View on PubMed)

Porayette P, Madathil S, Sun L, Jaeggi E, Grosse-Wortmann L, Yoo SJ, Hickey E, Miller SP, Macgowan CK, Seed M. MRI reveals hemodynamic changes with acute maternal hyperoxygenation in human fetuses with and without congenital heart disease. Prenat Diagn. 2016 Mar;36(3):274-81. doi: 10.1002/pd.4762. Epub 2016 Feb 9.

Reference Type BACKGROUND
PMID: 26701792 (View on PubMed)

Sun L, Macgowan CK, Sled JG, Yoo SJ, Manlhiot C, Porayette P, Grosse-Wortmann L, Jaeggi E, McCrindle BW, Kingdom J, Hickey E, Miller S, Seed M. Reduced fetal cerebral oxygen consumption is associated with smaller brain size in fetuses with congenital heart disease. Circulation. 2015 Apr 14;131(15):1313-23. doi: 10.1161/CIRCULATIONAHA.114.013051. Epub 2015 Mar 11.

Reference Type BACKGROUND
PMID: 25762062 (View on PubMed)

Porayette P, van Amerom JF, Yoo SJ, Jaeggi E, Macgowan CK, Seed M. MRI shows limited mixing between systemic and pulmonary circulations in foetal transposition of the great arteries: a potential cause of in utero pulmonary vascular disease. Cardiol Young. 2015 Apr;25(4):737-44. doi: 10.1017/S1047951114000870. Epub 2014 Jun 16.

Reference Type BACKGROUND
PMID: 24932863 (View on PubMed)

Prsa M, Sun L, van Amerom J, Yoo SJ, Grosse-Wortmann L, Jaeggi E, Macgowan C, Seed M. Reference ranges of blood flow in the major vessels of the normal human fetal circulation at term by phase-contrast magnetic resonance imaging. Circ Cardiovasc Imaging. 2014 Jul;7(4):663-70. doi: 10.1161/CIRCIMAGING.113.001859. Epub 2014 May 29.

Reference Type BACKGROUND
PMID: 24874055 (View on PubMed)

Mawad W, Chaturvedi RR, Ryan G, Jaeggi E. Percutaneous Fetal Atrial Balloon Septoplasty for Simple Transposition of the Great Arteries With an Intact Atrial Septum. Can J Cardiol. 2018 Mar;34(3):342.e9-342.e11. doi: 10.1016/j.cjca.2017.12.010. Epub 2017 Dec 15.

Reference Type BACKGROUND
PMID: 29398177 (View on PubMed)

Jaeggi E, Renaud C, Ryan G, Chaturvedi R. Intrauterine therapy for structural congenital heart disease: Contemporary results and Canadian experience. Trends Cardiovasc Med. 2016 Oct;26(7):639-46. doi: 10.1016/j.tcm.2016.04.006. Epub 2016 Apr 22.

Reference Type BACKGROUND
PMID: 27234352 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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1000060514

Identifier Type: -

Identifier Source: org_study_id

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