Ultrasound for Congenital Fetal Anomalies by Sonal Panchal

Author:Sonal Panchal [Panchal, Sonal]
Language: eng
Format: epub
Publisher: Jaypee Brothers Medical Publishers
Published: 2016-11-29T18:30:00+00:00

CHAPTER 7 Fetal Cardiac Defects

133

Figure 47: Left aortic arch with aberrant right Figure 48: The great vessels in the three vessel view are subclavian artery. Three vessel trachea view with ARSA placed too close to the anterior chest wall in this case seen arising from the apex of the ‘V’ and coursing to the of double outlet right ventricle. The thymus is either right side. The trachea is marked by arrow

absent or grossly hypoplastic

A

B

Figure 49: (A) Single artery (aorta–arrow) seen in the three vessel view in a case of common arterial trunk; (B) Persistent left superior vena cava (arrow) in the three vessel view is the fourth vessel artery in hypoplastic left heart syndrome and Persistent Left SVC

pulmonary atresia with intact ventricular

septum respectively may be so small in caliber This is the most common venous variant in that they may not be identified by gray scale the thorax. Coexisting cardiac malformation ultrasound thus causing only two vessels to (heterotaxy, conotruncal abnormalities and be seen in the three vessel trachea view. Color left ventricular outflow tract obstruction) is Doppler helps in identifying the vessel.

seen in about 5% of cases. The right superior

There may be four vessels seen in the three vena cava may or may not be present. The left vessel trachea view. This happens in persistent superior vena cava is identified as an extra left superior vena cava (SVC).

vessel to the left of the pulmonary artery in

Chap-07.indd 133

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Ultrasound for Congenital Fetal Anomalies

134 the three vessel view (Figure 49B). It may also 5. Smith RS et al. Ultrasonographic left cardiac be identified in the left atrioventricular groove

axis deviation – a marker of fetal anomalies.

in the four chamber view. The coronary sinus

Obstet Gynecol. 1995;85(2):187-91.

(into which it drains) is prominent (3 to 7 6. Lincoln C, Jamieson S, Shinebourne E, et al.

mm)21 and can be recognized when the probe

Transatrial repair of ventricular septal defects

is angled caudally from the four chamber

with reference to their anatomic classification.

J Thoracic Cardiovasc Surg. 1977;74:183-90.

view. Differential diagnosis is the vertical 7. Machlitt A, Heling KS, Chaoui R. Increased vein in supracardiac total anomalous venous

atrioventricular length ratio in fetal four

drainage. Color Doppler will demonstrate

chamber view:a new marker for atrioventricular

caudocranial flow direction in a vertical vein

septal defect. Ultrasound Obstet Gynecol.

(in contrast to craniocaudal flow direction in

2004;24(6):618-22.

the left superior vena cava).

8. Van Praagh R, Van Praagh S, Vlad P, et al.

Diagnosis of the anatomic types of single or

Miscellaneous Abnormalities

common ventricle. Am J Cardiol. 1965;15:345-66.

9. Hornberger LS, Sanders SP, Rein AJ, et

Tracheal dilatation may be recognized in

al, Left heart obstructive lesions and left

the three vessel view in congenital high

ventricular growth in the mid trimester

airway obstruction sequence (CHAOS). An

fetus. A Longitudinal study. Circulation

esophageal duplication cyst or a neurenteric

1995;92(6):1533-8.

cyst may be picked up in the three vessel view.

10. Wong SF, Ward C, Lee-Tannock A, Le S, Chan

Thus we see that a systematic examination

FY. Pulmonary artery/aorta ratio in simple

screening for fetal outflow tract abnormalities

using the standard planes of section is

during the second trimester. Ultrasound Obstet

necessary for the recognition of findings.

Gynecol. 2007;30: 275-80.

Integrating these findings together yields 11.

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