Document Detail


Prenatal diagnosis of vascular rings.
MedLine Citation:
PMID:  20103801     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this series was to identify vascular rings prenatally on fetal echocardiograms. METHODS: We reviewed the fetal echocardiograms and clinical histories of 9 patients with a diagnosis of vascular rings at our institution from 2004 to 2009. Eight patients had a prenatal diagnosis by fetal echocardiography. One other patient who had undergone fetal echocardiography had a diagnosis of a vascular ring and a cervical arch only postnatally. RESULTS: Among the 8 patients with a prenatal diagnosis (4 with a double aortic arch and 4 with a right aortic arch [RAA], an aberrant left subclavian artery, and a left ductus arteriosus [LDA]), the vascular ring was isolated in 4 and associated with other structural congenital heart disease in 4. In all 8 patients with a prenatal diagnosis, the vascular ring was identified by cephalad transducer sweeps from a 3-vessel view (3VV) with and without color Doppler imaging, which revealed vascular structures coursing around the trachea. Seven of these patients had postnatal confirmation of the abnormality (there was 1 pregnancy termination without autopsy). The only known vascular ring missed at fetal echocardiography but diagnosed after birth was that associated with a cervical RAA (which could not be visualized in cross-sectional sweeps) and an LDA evaluated only late in pregnancy. Only 3 of the 8 postnatally treated neonates had clinical symptoms of the vascular ring, and 5 underwent surgical division of the ring. CONCLUSIONS: Vascular rings can be largely identified before birth with cephalad sweeps from the 3VV with attention to the relationship of the aortic and ductal arches to the trachea on fetal echocardiograms.
Authors:
Supriya Jain; Beth Kleiner; Anita Moon-Grady; Lisa K Hornberger
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  29     ISSN:  1550-9613     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-05-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  287-94     Citation Subset:  IM    
Affiliation:
Fetal and Neonatal Cardiology Program, University of Alberta, Department of Pediatrics, Division of Cardiology, Stollery Children's Hospital, Walter C. Mackenzie Health Sciences Centre, 4C2, 8440 112th St, Edmonton, Alberta, T6G2B7 Canada.
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple / embryology,  ultrasonography*
Aortic Arch Syndromes / embryology,  ultrasonography*
Female
Heart Defects, Congenital / embryology,  ultrasonography*
Humans
Male
Ultrasonography, Prenatal / methods*

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