Document Detail


Transposition of the great arteries in the fetus: assessment of the spatial relationships of the arterial trunks by four-dimensional echocardiography.
MedLine Citation:
PMID:  18307212     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Coronary arterial abnormalities can be one of the few negative prognostic indicators in transposition of the great arteries (TGA), and their occurrence is related to the type of spatial relationship of the great arteries. The main objective of this study was to assess whether the use of the reconstructed en-face view with color Doppler imaging of the four cardiac valves can demonstrate the different types of spatial relationship of the arterial trunks in fetuses with TGA, in order to derive the risk of coronary abnormalities. A secondary end-point was the evaluation of the type of coronary arterial branching pattern. METHODS: Twenty-three fetuses with a confirmed diagnosis of TGA underwent four-dimensional (4D) echocardiography at 19-33 gestational weeks. The en-face view of the four cardiac valves and color Doppler with high persistence were employed to assess the spatial relationships of the great arteries. In all cases, confirmation of the vessels' arrangement and coronary arterial distribution was obtained at neonatal echocardiography and/or surgery. RESULTS: The spatial relationships of the great vessels was identified correctly in 20/23 (87%) cases. The aorta was found to be located anterior to and to the right of the pulmonary trunk in 13/23 (56.5%) cases and just anterior to the pulmonary artery in 6/23 (26.1%) cases; in the remaining four (17.4%) cases, the two vessels were side by side. With respect to the association between the spatial relationship of the great arteries and the occurrence of an unusual pattern of coronary arterial branching, five of the TGA fetuses had abnormal coronary arterial distribution. CONCLUSIONS: Using 4D echocardiography with color Doppler, it is possible to define the spatial relationships of the great arteries in fetuses with TGA with a high degree of accuracy. This information can be used during counseling to predict the likelihood of abnormal coronary arterial distribution.
Authors:
D Paladini; P Volpe; G Sglavo; M Vassallo; V De Robertis; M Marasini; M G Russo
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  31     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-05     Completed Date:  2008-08-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  271-6     Citation Subset:  IM    
Copyright Information:
(c) 2008 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Fetal Cardiology Unit, Department of Gynecology and Obstetrics, University Federico II of Naples, Italy. paladini@unina.it
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MeSH Terms
Descriptor/Qualifier:
Coronary Vessels / embryology,  ultrasonography
Echocardiography, Doppler, Color / methods*
Echocardiography, Four-Dimensional / methods*
Female
Heart Valves / embryology,  ultrasonography
Humans
Image Interpretation, Computer-Assisted*
Infant, Newborn
Pregnancy
Pregnancy Trimester, Second
Prospective Studies
Risk Assessment / methods
Transposition of Great Vessels / ultrasonography*
Ultrasonography, Prenatal / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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