Fetal cardiac asymmetry: a marker for congenital heart disease

Kirk, Janet S.; Comstock, Christine H.; Lee, Wesley; Smith, Ramada S.; Riggs, Thomas W.; Weinhouse, Elliott

doi:10.1016/s0029-7844(98)00391-3

Cited by 35 publications

(33 citation statements)

References 19 publications

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“…E-mail: manuelarteagamartinez@yahoo.com Among the consequences of wide-spread use of fetal echocardiography has been the realization that to obtain an accurate diagnosis, through clear differentiation between normal heart and congenital heart disease, the morphometric dimensions of the different segments of the human heart must be known precisely (Fyfe and Kline, 1990). Presently, there are only a few morphologically based studies supporting the use of fetal echocardiography and most of these have been carried out in evaluations of patients suffering from congenital cardiopathies (Allan et al, 1980(Allan et al, , 1984(Allan et al, , 1997Lapasset et al, 1986;Paladini et al, 1990;Sun et al, 1999;Kirk et al, 1999). Although there is little doubt that the echocardiogram used as a diagnostic test has good sensitivity to detect congenital malformations, neither its specificity nor its predictive value, have been fully analyzed and described.…”

Section: Introductionmentioning

confidence: 99%

Morphometric study of the human fetal heart I. Arterial segment

et al. 2005

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This study measured the dimensions of the great arteries of normal human fetal hearts at an early fetal stage (between 13-20 weeks post-fertilization) in 103 fetuses obtained by necropsy. Different segments of the aorta and the pulmonary artery were dissected and their external diameters measured under stereoscopic magnification. All segments showed linear growth during this period of fetal development. Ranges in median values of external diameters associated with the pulmonary artery were: 2.1-4.2 mm for the valve ring; 2.2-4.2 mm for the main pulmonary trunk; 1.2-2.5 mm for the right pulmonary artery; 0.9-2.18 mm for the left pulmonary artery; and 4.0-8.0 mm for the length of the main pulmonary trunk. Similarly, in the aorta, median diameters were: 2.1-4.2 mm for the ascending aorta; 1.92-3.8 mm for the aortic arch; 1.45-3.0 mm for the aortic isthmus; and 1.75 -3.35 mm for the descending aorta. The diameter of the ductus arteriosus ranged between 1.2-2.45 mm. The growth rates of the pulmonary artery and the aorta were similar. The diameter of the ascending aorta was found to be greater than that of the descending aorta and the right pulmonary artery was wider than the left pulmonary artery. In addition, the magnitude of growth in the various aortic segments was different and the ratios obtained between the aortic isthmus and the ascending and descending aortae, ranged between 0.66-0.93. This study provides important morphometric reference information concerning the dimensions and growth of the great arteries of the fetal heart and has clinical application in pediatric cardiac surgery and echocardiography.

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Section: Introductionmentioning

confidence: 99%

Morphometric study of the human fetal heart I. Arterial segment

et al. 2005

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“…Cardiac asymmetry, either ventricular or great arterial, was present in two‐thirds of fetuses with cardiac anomalies diagnosed prenatally but not across the spectrum of fetal heart defects 14 . Cardiac defects that can cause a larger right heart or a smaller left heart may lead to prevalence of the right heart; therefore, prevalence of the right heart may be absolute or relative.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis of Prevalence of the Right Heart

Ruan

Xie

Zhu

et al. 2014

J of Ultrasound Medicine

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“…This retrospective cohort study included fetuses of pregnant women who were referred to our fetal heart center for extended echocardiography at Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China, between January 2014 and October 2017. Major inclusion criteria were as follows: (a) prenatal diagnosis of isolated ventricular disproportion with a dominant right ventricle (RV/LV ratio > 1.2 at any point in pregnancy according to previous studies), and the cases were excluded if the ratio changed below the cut‐off value during pregnancy; (b) singleton fetus without aneuploidy (karyotyping was performed in all cases in the present study); (c) absence of extracardiac malformations; and (d) the size of the fetus is consistent with the gestational age according to the measurements of biparietal diameter, femur length, abdominal circumference, and head circumference. Fetuses were excluded if unequivocal cardiac malformations were demonstrated on echocardiography including left ventricular hypoplasia, mitral valve or aortic valve stenosis, obvious coarctation of the aorta, double outlet of the right ventricle, tricuspid valve abnormalities like Ebstein anomaly, coronary artery fistula to the right heart system, and totally anomalous pulmonary venous connection.…”

Section: Methodsmentioning

confidence: 99%

Neonatal outcome of cases with isolated prenatal ventricular disproportion with a dominant right ventricle

et al. 2019

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Objectives Isolated prenatal ventricular disproportion with a dominant right ventricle represents a challenge in decision‐making for both physicians and pregnant women. In the current study, we sought to delineate the postnatal outcomes of these cases. Methods This retrospective analysis included consecutive cases of isolated ventricular disproportion identified using complete fetal echocardiography at the Fetal Heart Center of Xinhua Hospital from January 2014 to October 2017. Postnatal cardiac outcome was examined using transthoracic echocardiography within the first 6 months after birth. Results A total of 90 fetuses were included in the final analysis. The median gestational age (GA) at diagnosis was 29 weeks (range 24 to 36). At postnatal examination, cardiac malformations were detected in 39 cases (43.3%), including 25 (27.8%) cases of congenital cardiac septal defects, eight (8.9%) of persistent left superior vena cava, four (4.4%) of left‐sided obstructive diseases, and one (1.1%) case of coronary fistula. Nineteen cases (21.1%) with fetal cardiac malformations had significant lower GA at diagnosis (P = .01) and greater right to left ventricle ratio (1.38 vs 1.30, P = .02). Neonatal surgical intervention was not required in any of the cases. Conclusions Isolated prenatal ventricular disproportion with a dominant right ventricle comprises minor postnatal cardiac malformations and doesn't require neonatal intervention.

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Fetal cardiac asymmetry: a marker for congenital heart disease

Abstract: Cardiac asymmetry was present in two-thirds of fetuses with cardiac anomalies diagnosed prenatally. If cardiac asymmetry is found, a more thorough examination of the fetal heart is indicated.

Cited by 35 publications

References 19 publications

Morphometric study of the human fetal heart I. Arterial segment

Morphometric study of the human fetal heart I. Arterial segment

Prenatal Diagnosis of Prevalence of the Right Heart

Neonatal outcome of cases with isolated prenatal ventricular disproportion with a dominant right ventricle

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