Background Isolated agenesis of ductus venosus (ADV) is usually a benign
condition, but it may be associated with cardiovascular defects, hydrops, growth
restriction, and chromosomal abnormalities. Additionally, persistent left
superior vena cava (PLSVC) and bovine aortic arch are relatively common fetal
anomalies. To the author’s knowledge, this is the first report of
prenatal detection of DV agenesis and PLSVC associated with the postnatal bovine
aortic arch with a hypoplastic transverse aortic arch.
Case A 25-year-old, G2P1 woman was referred to our department at 31 weeks
due to fetal growth restriction and short femur. On fetal echocardiography, DV
could not be viewed via two-dimensional (2D) and Doppler ultrasound (US)
imaging; there was also evidence of the co-occurrence of PLSVC and an aortic
arch anomaly. We revealed the intrahepatic continuation of the umbilical vein. A
weekly follow-up program was scheduled for the patient and the rest of the
pregnancy was uneventful. Postnatal, thorax computer tomography and
transthoracic echocardiography (TTE) demonstrated PLSVC and bovine aortic arch
associated with hypoplastic transverse aortic arch. Routine echocardiographic
examinations revealed that the blood flow of the aortic arch had increased
gradually, and the male infant’s aortic arch had significantly widened
and reached the normal range until the baby was discharged from the
hospital.
Conclusion DV agenesis and PLSVC are usually benign conditions but
underlying serious heart diseases may accompany them. Therefore, in situations
like ours, a prenatal aortic arch evaluation is of capital importance. Postnatal
hemodynamic changes should be taken into consideration in the management of
these cases. This is the first example in the literature that these
abnormalities co-existed in one case.