Conotruncal anomalies in fetal life: Accuracy of diagnosis, associated defects and outcome

Galindo, Alberto; Mendoza, Alberto; Arbués, J.; Grañeras, A.; Escribano, David; Nieto, Olga

doi:10.1016/j.ejogrb.2009.04.032

Cited by 65 publications

(76 citation statements)

References 25 publications

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“…Previous studies have shownthat the improvements in fetal echocardiography allow CAT to be diagnosed prenatally with a high degree of accuracy (78.6-95.8%) [2,3,4,5]. However, in the present study, the accuracy with which CAT was diagnosed prenatally was 71%, which was lower in comparison with other studies.…”

Section: Discussioncontrasting

confidence: 91%

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Prenatal Diagnosis of Common Arterial Trunk: A Single-Center's Experience

Lee¹,

Won²,

Lee

et al. 2013

Fetal Diagn Ther

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Introduction: To report our experience in fetuses prenatally diagnosed with common arterial trunk (CAT) and to evaluate the postnatal outcomes. Material and Methods: This was a retrospective study conducted at Asan Medical Center, Seoul, Korea, between 2003 and 2012. Maternal medical and fetal echocardiographic records regarding fetuses were prenatally diagnosed with CAT were reviewed. Postnatal outcomes of survivors were also assessed during the mean follow-up of 36 months. Results: Of the 17 fetuses that were prenatally diagnosed with CAT and had a final diagnosis by postnatal echocardiography or autopsy, 12 were confirmed to have CAT and 5 were incorrectly diagnosed with CAT. Of the latter, 3 had pulmonary atresia and 2 had aortic atresia. The diagnostic accuracy was 71%. The median gestational age at prenatal diagnosis of confirmed CAT was 24.4 weeks (range 21.1-34.3). The truncal valve was prenatally thickened in 8 fetuses. All but 1 of the 12 confirmed CAT cases had associated heart and/or extracardiac anomalies. Of the 8 liveborn cases of postnatally confirmed CAT, 2 died before or after surgery respectively. The remaining 6 remained alive after successful corrective surgery. Conclusion: Prenatal diagnosis of CAT can be difficult in some cases and other diseases should be excluded before diagnosing CAT. Isolated CAT can be repaired by postnatal corrective surgery with a good outcome.

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Section: Discussioncontrasting

confidence: 91%

“…Several studies examining the accuracy of prenatal diagnosis of CAT have been reported (78.6-95.8%) [2,3,4,5]. Although CAT can be diagnosed with a high degree of accuracy, it is sometimes difficult to make a diagnosis when only the single great vessel is identified by fetal echocardiography.…”

Section: Introductionmentioning

confidence: 99%

Prenatal Diagnosis of Common Arterial Trunk: A Single-Center's Experience

Lee¹,

Won²,

Lee

et al. 2013

Fetal Diagn Ther

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“…Prenatal detection of conotruncal anomalies has greatly improved in the last years [1,2,3,4]. Nonetheless, a differentiation between conotruncal anomalies may be difficult, with a particular potential for confusion between truncus arteriosus communis (CAT) and pulmonary atresia with ventricular septal defect (PA-VSD).…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Fetal Echocardiography in the Differential Diagnosis between Truncus Arteriosus and Pulmonary Atresia with Ventricular Septal Defect

et al. 2015

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Objectives: To report on the accuracy of fetal echocardiography in the distinction between truncus arteriosus communis (CAT) and pulmonary atresia with ventricular septal defect (PA-VSD) and to describe the association with extracardiac and chromosomal anomalies. Methods: This was a retrospective study on 31 fetuses with a single arterial trunk overriding a VSD with a nonidentifiable right ventricle outflow tract with anterograde flow. Data on the type of cardiac defect, gestational age, characteristics of the arterial trunk valve, presence of additional vascular, chromosomal and extracardiac abnormalities and postnatal outcome were obtained. Misdiagnosed cases were reevaluated by four-dimensional spatiotemporal image correlation (4D-STIC) echocardiography. Results: The overall diagnostic accuracy was 81% and increased to 93.5% with 4D-STIC. Chromosomal and extracardiac anomalies were detected in 40 and 27%, respectively. In the PA-VSD group, patent ductus arteriosus and major aortopulmonary collateral arteries (MAPCAs) were present in 70 and 50% of the cases, respectively, coexisting in 1 of 5 cases. MAPCAs were significantly associated with a right aortic arch and with a 22q11 microdeletion in 50% of cases. Conclusions: A prenatal distinction between CAT and PA-VSD can currently be achieved in most cases. MAPCAs should be actively searched for when PA-VSD is suspected, as they are associated with a higher risk of 22q11 microdeletion and potentially complicate postnatal treatment.

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“…Although TGA situates among the major CHD with the best outcome results [4], the survival rate reported differs widely between series, from 75-80% to 98-99%, depending on factors such as the type of TGA or the presence of coronary anomalies [5,6,7,8,9,10]. …”

Section: Introductionmentioning

confidence: 99%

“…Prenatal diagnosis of TGA is becoming increasingly more common [11], but the degree of accuracy of fetal echocardiography to establish the type of TGA remains largely unexplored [4]. However, this is of paramount importance, since the prenatal counselling offered to parents relies almost completely on the type of TGA.…”

Section: Introductionmentioning

confidence: 99%

Transposition of the Great Arteries in Fetal Life: Accuracy of Diagnosis and Short-Term Outcome

Domínguez-Manzano

Mendoza²,

Herraı̀z³

et al. 2016

Fetal Diagn Ther

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Objective: To review our series of prenatally diagnosed transposition of the great arteries (TGA) to analyze the accuracy of fetal echocardiography for achieving a precise diagnosis of the TGA type (simple vs. complex) and to examine the short-term outcome. Methods: A total of 94 cases of simple and complex TGA types (ventriculoarterial discordance with atrioventricular concordance) prenatally evaluated in our referral center between 1998 and 2014 were included. Fetuses with additional congenital anomalies and those with incomplete follow-up were excluded. Prenatal diagnostic accuracy and short-term survival were analyzed for the different types of TGA. Results: The TGA type was correctly ascertained prenatally in 93.3%. Most fetuses were diagnosed with simple TGA (62.7%). There were 6 discrepancies: 5 fetuses with simple TGA had postnatally TGA + ventricular septal defect (VSD; n = 3) or TGA + VSD + coarctation of the aorta (n = 2), and 1 fetus with TGA + VSD postnatally showed severe left ventricular outflow tract obstruction. The mortality rate was 6.6%; it was higher in complex versus simple forms (12.8 vs. 1.9%, p = 0.038), and in cases with intramural coronary artery versus those without (60 vs. 3.5%, p < 0.001). We found no relationship between the arrangement of the great arteries and coronary arterial abnormalities. Conclusions: Simple TGA has a better outcome than the complex forms. A discrepancy rate of 7% with potential influence on the prognosis of survival between the prenatal diagnosis of the TGA type and the definitive diagnosis was found.

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Conotruncal anomalies in fetal life: Accuracy of diagnosis, associated defects and outcome

Cited by 65 publications

References 25 publications

Prenatal Diagnosis of Common Arterial Trunk: A Single-Center's Experience

Prenatal Diagnosis of Common Arterial Trunk: A Single-Center's Experience

Accuracy of Fetal Echocardiography in the Differential Diagnosis between Truncus Arteriosus and Pulmonary Atresia with Ventricular Septal Defect

Transposition of the Great Arteries in Fetal Life: Accuracy of Diagnosis and Short-Term Outcome

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