EP10.09: HDliveFlow mode and spatiotemporal image correlation in the diagnosis of congenital double aortic arch (original) (raw)
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Right aortic arch detected in fetal life
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2006
To evaluate the prenatal distribution, associated conditions and outcome of the different types of right aortic arch (RAA) detected in fetal life. This was a retrospective review of all cases of RAA detected prenatally between 1998 and 2005 in two tertiary referral centers. In the study period 71 cases of RAA were detected; 26 (37%) had RAA with aberrant left subclavian artery, 23 (32%) had RAA with mirror-image branching, 20 (28%) had RAA of unknown type and two (3%) had double aortic arch. While 20/26 cases with RAA and aberrant left subclavian artery were isolated findings, all 23 cases with RAA and mirror-image branching were associated with cardiac defects, namely tetralogy of Fallot (43%) or pulmonary atresia with ventricular septal defect (22%). Of the 20 cases with RAA, 19 of unknown type were associated with heterotaxy syndromes and had additional cardiac malformations and ambiguities of the situs. The two cases with DAA were isolated findings. Seven cases in our series (10...
Prenatal echocardiographic assessment of right aortic arch
Ultrasound in Obstetrics & Gynecology, 2019
Objectives. To report our experience with fetal diagnosis of right aortic arch (RAA) variants based on the ductus arteriosus (DA) anatomy and brachiocephalic vessel branching pattern (BVBP) respectively to the trachea and to establish whether the echocardiographic "Vshaped" or "U-shaped" appearances of the fetal upper mediastinum were sufficiently accurate for fetal aortic arch (AA) assessment. Methods. We retrospectively identified patients with a fetal diagnosis of RAA referred to our tertiary center from 2011 to 2017 and selected those who had post-natal confirmation of AA anatomy. Prenatal and postnatal medical records, including echocardiographic and CT/MRI scan reports, were reviewed and cardiac and extracardiac abnormalities and the results of genetic testing were recorded. Results. Among 55 consecutive fetuses with a diagnosis of RAA, 6 patients were lost to follow-up, 1 pregnancy was interrupted and 3 patients were excluded for lack of post-natal confirmation. In the remaining 45 patients the AA anatomy was studied after birth by CT in 39, MRI in 1, and only by direct exploration at cardiac surgery in 5 patients. Fetal "U-shaped" appearance was found in 37/45 patients (82%) and all had a complete vascular ring (CVR). Of those, at post-natal confirmation, 21/37 patients (57%) had RAA with Kommerell diverticulum, left posterior ductus arteriosus (LPDA) and aberrant left subclavian artery (ALSA) (RAA/LPDA/ALSA), 11/37 patients (30%) double aortic arch (DAA), 4/37 patients (11%) RAA with Kommerell diverticulum, LPDA and mirror image (MI) branching (RAA/LPDA/MI), 1/37 patient (2%) RAA with Kommerell diverticulum, LPDA and aberrant innominate artery (ALIA)
Aortic arch anomalies detected in foetal life by echocardiography
Journal of Obstetrics and Gynaecology, 2018
Aortic arch anomalies refer to congenital malformations of position or branching pattern of the aortic arch. To-date, only a few small studies have documented prenatal detection of aortic arch anomalies. In this article, we share our experience in detecting aortic arch anomalies. Foetal echocardiograms, clinic and genetic histories of 33 patients who had been diagnosed with aortic arch anomaly from 2007 to 2015 were reviewed. In 15 patients, right aortic arch with mirror image branching; in 13 patients, right aortic arch with left ductus arteriosus and aberrant left subclavian artery; in three patients, left aortic arch with aberrant right subclavian artery; in one patient bilateral ductus and right aortic arch with aberrant left subclavian artery and in one patient double aortic arch were detected. In a patient with isolated right aortic arch, 22q11 microdeletion had been revealed. Given this data, we strongly suggest foetal karyotype analysis when aortic arch anomalies are identified. KEYWORDS Right aortic arch with mirror image branching; right aortic arch with left ductus arteriosus and aberrant left subclavian artery; double aortic arch; aortic arch anomalies; foetal echocardiography CONTACT Sezen Ugan Atik
Perinatal outcomes and anomalies associated with fetal right aortic arch
Journal of the Turkish German Gynecological Association, 2012
To evaluate the prenatal findings, associated anomalies, and prognosis of right aortic arch (RAA) anomalies. Material and Methods: All cases referred for detailed ultrasonography and fetal echocardiography between October 2006 and July 2009 were systematically examined for aortic arch anomalies and associated cardiac and extracardiac anomalies. Prenatal findings of all cases with aortic arch anomalies and intracardiac and extracardiac findings were prospectively registered in an electronic database that included fetal echocardiography. Outcomes of the cases were collected postnatally from the patients' obstetricians, neonatal unit archieves, and pediatric cardiologists. Results: We detected 12 cases of RAA (0.37%; n=12/3200). Mean gestational age at diagnosis was 24 weeks (range, 21-33 weeks). Of the 12 cases of RAA, five (41.7%) had a major cardiac defect, including tetralogy of Fallot (n= 3), atrioventricular septal defect (n=1), and ventricular septal defect (n=1). An extracardiac anomaly was observed in three cases (25%). The fetal karyotype was trisomy 21 in one case with increased nuchal translucency (6.6 mm). Microdeletion 22q11 analyses performed in three cases were normal. The postnatal courses of the cases with isolated RAA were uneventful. Two cases associated with major cardiac and extracardiac anomalies were lost in the early neonatal period. The case of trisomy 21 was terminated. The other four cases of RAA with an associated cardiac anomaly are currently in follow up. Conclusion: Aortic arch anomalies, particularly RAA, can be diagnosed by fetal echocardiography. The prognosis for isolated RAA is relatively good compared with that for RAA with associated anomalies.
Cardiology in the Young, 2014
We present a case of double aortic arch with a predominant right and a double arterial duct detected by echocardiogram in a 28-week gestation foetus. The first evaluation revealed that both arches were perfused; the 1-month postnatal echocardiogram showed the closure of both arterial ducts and the partial obliteration of the left aortic arch between the left subclavian artery and the dorsal aorta. In our case, the postnatal obliteration of the left arch in a double aortic arch was probably due to the closure of the left-sided arterial duct.
Journal of Cardiovascular Development and Disease
Abnormal aortic arches (AAAs) cover a spectrum of malformations, including abnormal laterality, branching patterns, and flow-limiting narrowing, which themselves vary from tubular hypoplasia, through discrete coarctation, to complete interruption of the arch. Neonatal surgery within the first days of life is necessary for most of these morphologies. Patch aortoplasty is widely used as it can offer a good haemodynamic result, being tailored to each combination of presenting pathologies. Our study hypothesis was that arch malformations are frequent in DORV and exhibit a plethora of phenotypes. We reviewed 54 post-mortem heart specimens from the UCL Cardiac Archive, analysing morphological features that would potentially influence the surgical repair, and taking relevant measurements of surgical importance. AAAs were found in half of the specimens, including 22.2% with aortic arch narrowing. In total, 70% and 30% of narrow arches had a subpulmonary and subaortic interventricular defect...
Fetal interrupted aortic arch: 2D-4D echocardiography, associations and outcome
Ultrasound in Obstetrics and Gynecology, 2010
Objectives To analyze fetal two-dimensional (2D) echocardiographic characteristics of interrupted aortic arch (IAA) and its different types, to explore whether the use of 4D ultrasound with B-flow imaging and spatiotemporal image correlation (STIC) can improve prenatal diagnostic accuracy, and to describe associations and outcome.
Double Aortic Arch - a Case Report
Pakistan Armed Forces Medical Journal, 2021
Double Aortic Arch is a rare congenital cardiovascular anomaly. Its first successful surgery was performed by Robert Gross in 1945 at Children Hospital Boston, USA. It accounts for 0.4 to 1% of all congenital cardiac defects. Patients having a Double Aortic Arch mostly present with symptoms in the 1st week of life but depending upon the severity of symptoms can present at any age in childhood. We present a case report of two month old baby with noisy breathing, intermittent cough, gross jugular notch retraction and sub costal recession. His Cardiac CT was subsequently done which showed a Double Aortic Arch of left dominant variety encircling the trachea. Surgery was done and the encircling artery compressing the trachea was recognized, dissected and interrupted. Marked relief of tracheal and/or esophageal compression was evident from operation day. Post operative recovery was speedy. Patient’s follow up of was done at 1, 4 and 24 weeks. His recovery was unremarkable. Currently he wa...