Fetal echocardiographic diagnosis of vascular rings
Acoustics; anomalies; aortic-arch; fetal echocardiography; low-risk; Nuclear Medicine & Medical Imaging; prenatal diagnosis; Radiology; sonographic diagnosis; vascular ring; view
Objective. The purpose of this series is to describe the prenatal echocardiographic findings of vascular rings. Methods. The 3-vessel and trachea view consists of the axial view of the upper mediastinum. The normal left aortic arch appears as a V-shaped confluence of the ductus arteriosus and aortic arch, with the trachea situated posterior and to the right. No vessel should encircle the trachea. The diagnoses of vascular rings were made prenatally and were confirmed in all patients postnatally. Results. Six fetuses had diagnoses of vascular rings. The mean gestational age at diagnosis was 23.3 weeks (range, 18-31 weeks). The indications for fetal echocardiography were family history of congenital heart disease, echogenic focus in the left ventricle, and abnormal 4-chamber view. There were 2 fetuses with a double aortic arch; 3 fetuses with a right aortic arch, an aberrant left subclavian artery, and a left ductus arteriosus; and 1 with a right circumflex aortic arch with a left ductus arteriosus and an aberrant left subdavian artery. Two fetuses had associated structural cardiac defects, 1 with an unbalanced atrioventricular septal defect and trisomy 21 and the other with a double-outlet right ventricle, pulmonary atresia, and multiple other congenital anomalies. Conclusions. Vascular rings can be accurately diagnosed prenatally with recognition of a vascular structure that courses around the trachea and absence of the usual V-shaped relationship of the aortic and ductal arches. The color Doppler findings and the presence of a ductus arteriosus aid in identifying various components of the vascular ring.
Patel C R; Lane Jr; Spector M L; Smith P C
Journal of Ultrasound in Medicine
2006
2006-02
Journal Article
<a href="http://doi.org/10.7863/jum.2006.25.2.251" target="_blank" rel="noreferrer noopener">10.7863/jum.2006.25.2.251</a>
Tetralogy of Fallot with an aortopulmonary septal defect - Prenatal diagnosis
Acoustics; fetal echocardiography; Nuclear Medicine & Medical Imaging; Radiology; repair; window
An aortopulmonary septal defect is a rare cardiac malformation in which there is a communication between the ascending aorta and pulmonary trunk in the presence of 2 separate semilunar valves. There are reports of postnatal diagnosis of aortopulmonary septal defects in association with tetralogy of Fallot.(1-4) Prenatal diagnosis of an aortopulmonary septal defect with tetralogy of Fallot is rare. We report a case of tetralogy of Fallot and an aortopulmonary septal defect diagnosed by fetal echocardiography at 30 weeks' gestation. The diagnosis was confirmed on postnatal cross-sectional echocardiography and at surgery.
Patel C R; Smith G L; Lane J R
Journal of Ultrasound in Medicine
2007
2007-08
Journal Article
<a href="http://doi.org/10.7863/jum.2007.26.8.1115" target="_blank" rel="noreferrer noopener">10.7863/jum.2007.26.8.1115</a>
Totally anomalous pulmonary venous connection and complex congenital heart disease - Prenatal echocardiographic diagnosis and prognosis
Acoustics; anomalous pulmonary venous connections; blood-flow; congenital heart diseases; fetal echocardiography; fetus; heterotaxy syndrome; Nuclear Medicine & Medical Imaging; pregnancy; prenatal diagnosis; Radiology; right isomerism; totally
Objective. The purpose of this study was to determine the accuracy of prenatal cardiac diagnosis, prognosis, and outcome of totally anomalous pulmonary venous connection (TAPVC) and to determine echocardiographic clues in the prenatal diagnosis of isolated TAPVC or TAPVC in association with other complex congenital heart disease (CHD). Methods. We reviewed our 13-year experience of prenatal diagnosis of TAPVC. Thirteen fetuses were identified with the diagnoses of TAPVC. We systematically analyzed the individual pulmonary veins by color and pulsed Doppler imaging, the presence of a pulmonary venous confluence, the pulsed and color Doppler evaluation of the vertical vein, and sites of connections. Prenatal diagnosis was confirmed by postnatal echocardiography, cardiac catheterization, surgery, or autopsy. Results. The mean gestational age at diagnosis of TAPVC was 26.3 weeks (range, 20-33 weeks). There were 8 fetuses with TAPVC and right isomerism, 3 fetuses with other associated CHD, and 2 with isolated TAPVC. There were 7 fetuses with supracardiac TAPVC, 4 with infracardiac TAPVC, and 2 with mixed TAPVC. Pulmonary vein color and pulsed Doppler data were available in 10 of 13 fetuses. The pulmonary venous confluence was visualized in all fetuses except 1. The vertical vein was visualized in all fetuses. Five fetuses had suspected signs of obstruction. The diagnosis was confirmed postnatally or at autopsy in 12 cases. Eight patients underwent surgery; 6 died, and 2 were alive. Two patients had compassionate care and died; 3 pregnancies were terminated. Conclusions. It is possible to diagnose accurately complex CHD, including the pulmonary venous connections. When diagnosed prenatally, TAPVC carries a poor prognosis.
Patel C R; Lane J R; Spector M L; Smith P C; Crane S S
Journal of Ultrasound in Medicine
2005
2005-09
Journal Article
<a href="http://doi.org/10.7863/jum.2005.24.9.1191" target="_blank" rel="noreferrer noopener">10.7863/jum.2005.24.9.1191</a>