A complex tetralogy of Fallot case with an unusual cluster of malformations diagnosed by multiple prenatal ultrasound views

Abstract

Background Tetralogy of Fallot (TOF) is a complex congenital anomaly with a wide variety of prenatal presentations beyond the core malformations, creating difficulty in prenatal diagnosis, prognosis, and perinatal management. Indeed, TOF should be considered the ‘complex’ of Fallot. Case presentation Through a series of precise prenatal ultrasound views, we describe a rare case of complex TOF with multiple malformations including main pulmonary artery atresia, left ductus arteriosus connecting subpulmonary arteries to the left innominate artery, and a right aortic arch with mirror image branching. The prenatal diagnosis and all ultrasound findings were confirmed by autopsy. Conclusions Tetralogy of Fallot (TOF) is a complex congenital anomaly with various branches of blood vessels. A set of standard views plus additional views (the upper chest coronal view) are required for prenatal diagnosis of complex TOF.