Document Detail

Tricuspid valve disease with significant tricuspid insufficiency in the fetus: diagnosis and outcome.
MedLine Citation:
PMID:  1987222     Owner:  NLM     Status:  MEDLINE    
The echocardiographic studies and clinical course of 27 fetuses (mean gestational age 26.9 weeks) diagnosed in utero with tricuspid valve disease and significant tricuspid regurgitation were reviewed. The diagnosis of Ebstein's anomaly was made in 17 of the fetuses, 7 had tricuspid valve dysplasia with poorly developed but normally attached leaflets and 2 had an unguarded tricuspid valve orifice with little or no identifiable tricuspid tissue. One fetus was excluded from data analysis because a more complex heart lesion was documented at autopsy. All fetuses had massive right atrial dilation and most who were serially studied had progressive right-sided cardiomegaly. Hydrops fetalis was found in six cases and atrial flutter in five. Associated cardiac lesions included pulmonary stenosis in five cases and pulmonary atresia in six. Four fetuses with normal forward pulmonary artery flow at the initial examination were found at subsequent study to have retrograde pulmonary artery and ductal flow in association with the development of pulmonary stenosis (n = 1) and pulmonary atresia (n = 3). On review of the clinical course of the 23 fetuses (excluding 3 with elective abortion), 48% of the fetuses died in utero and 35% who were liveborn died despite vigorous medical and, when necessary, surgical management, many of whom had severe congestive heart failure. Of the four infants who survived the neonatal period, three had a benign neonatal course, all of whom were diagnosed with mild to moderate Ebstein's anomaly; only one had pulmonary outflow obstruction. An additional finding at autopsy was significant lung hypoplasia documented in 10 of 19 autopsy reports.(ABSTRACT TRUNCATED AT 250 WORDS)
L K Hornberger; D J Sahn; C S Kleinman; J A Copel; K L Reed
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  17     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1991 Jan 
Date Detail:
Created Date:  1991-02-21     Completed Date:  1991-02-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  167-73     Citation Subset:  AIM; IM    
Department of Pediatrics, Division University of California-San Diego Medical Center, California.
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MeSH Terms
Ebstein Anomaly / mortality,  ultrasonography*
Fetal Diseases / mortality,  ultrasonography*
Fetal Heart / ultrasonography*
Retrospective Studies
Tricuspid Valve / abnormalities*
Tricuspid Valve Insufficiency / mortality,  ultrasonography*
Ultrasonography, Prenatal*

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