Cardiac axis shift within the cardiac cycle of normal fetuses and fetuses with congenital heart defect

Abstract

Objectives To investigate changes in the cardiac axis (CAx) within the cardiac cycle of normal fetuses and fetuses with congenital heart defects (CHD). Methods

Fetal cardiac axis in tetralogy of Fallot: associations with prenatal findings, genetic anomalies and postnatal outcome

“…Abnormal CAx is associated with many CHDs, especially conotruncal anomalies, of which TOF is an example. In a previous study, abnormal CAx was present in about one‐quarter of all CHD cases and in one‐third of cases with conotruncal anomalies. CAx was also found to be more prevalent in cases of fetal conotruncal anomalies with 22q11.2 deletion.…”

“…Measurements were obtained retrospectively at end‐systole on stored 4CV images by one author (Y.Z.). Inter‐ and intraobserver variability of CAx measurements were assessed in a previous study. Sidedness of the aortic arch and ductus arteriosus were determined in the 3VT view.…”

Correlation Between the Thymic‐Thoracic Ratio and Cardiac Axis in Healthy Fetuses

“…The cardiac axis is an ideal screening tool for CHD in all 3 trimesters . Conotruncal anomalies (eg, tetralogy of Fallot and a common arterial trunk) can bear a very high chance (≈50%) of an abnormal cardiac axis, which can also be found in 5% to 10% of healthy fetuses . Since an abnormal cardiac axis can be either physiologic or pathologic, understanding the cause of an abnormal cardiac axis may help better interpret this finding.…”

“…8,21,22 Conotruncal anomalies (eg, tetralogy of Fallot and a common arterial trunk) can bear a very high chance (50%) of an abnormal cardiac axis, which can also be found in 5% to 10% of healthy fetuses. 23 Since an abnormal cardiac axis can be either physiologic or pathologic, understanding the cause of an abnormal cardiac axis may help better interpret this finding. Typically, an extremely leftward-deviated axis (>758) is almost always pathologic because of either intracardiac anomalies or compression from extracardiac lesions.…”

Prenatal and Postnatal Survival of Fetal Tetralogy of Fallot

“…Tetralogy of Fallot is also associated with a series of additional sonographic findings, such as a right aortic arch, 21 , 23 , 24 an absent or hypoplastic fetal thymus, 13 a deviated cardiac axis, 46 – 50 an aberrant subclavian artery, 51 and an absent ductus arteriosus 12 , 16 , 18 , 40 . Given the limited publications about a deviated cardiac axis and an aberrant subclavian artery, we only included studies regarding a right aortic arch and an absent ductus arteriosus 12 , 14 , 16 , 18 , 19 , 20 , 22 – 25 , 28 , 31 – 33 , 37 – 41 .…”