OP35.10: Pulmonary atresia/critical stenosis with intact ventricular septum: prediction of outcome in the second trimester of pregnancy

Abstract

Objectives: To analyze the methods and echocardiographic characteristics of all kinds of aortic arch anomalies and to improve prenatal diagnostic accuracy. Methods: From 2004 to 2007, third-trimester screening of 41900 fetuses were performed in our hospital. 486 fetuses with congenital heart anomalies were diagnosed including 73 fetuses with congenital aortic arch anomalies. 73 fetuses with aortic arch abnormalities were classified by three aspects: aortic arch position anomalies relative to the trachea, the number of aortic arch anomalies, abnormal aortic arch diameter anomalies and aortic arch branch anomalies. We use different view to diagnosis aortic arch anomalies, including three vascular trachea view (3VT), trachea coronal view, thoracic aorta coronal view, longitudinal view of the aortic arch and longitudinal view of the ductus arch. Results: The details of 73 cases with congenital aortic arch anomalies were: 32 fetuses with malposition of aortic arch, 1 fetus with double aortic arch, 9 fetuses with normal left aortic arch and aberrant left subclavian artery, 5 fetuses with interrupted aortic arch, 26 fetuses with coarctation of aortic arch. 16 cases of 73 cases were done a chromosome examination, 7 cases which found chromosome abnormal were all 18-trisomy syndrome. The accuracy rate of prenatal sonographic diagnosis of congenital aortic arch anomalies was 86.36%. Conclusions: All kinds of aortic arch anomalies have typical sonographic image. If we know characteristics of all kinds of aortic arch anomalies, we could improve prenatal diagnostic accuracy. It is very useful to find and diagnosis aortic anomalies by using 3VT and trachea coronal view. It is also important to diagnosis interrupted aortic arch and coarctation of aortic arch by using color Doppler flow imaging. But coarctation of aortic arch was difficult diagnosed by prenatal ultrasound examination. Because it was very difficult to distinguish from interrupted aortic arch. OP35.10Pulmonary atresia/critical stenosis with intact ventricular septum: prediction of outcome in the second trimester of pregnancy Objectives: To determine which cardiac parameters provide the best prediction of postnatal outcome -biventricular (BV) vs. non-BV circulation-in fetuses with pulmonary atresia-critical stenosis with intact ventricular septum (PA/CS-IVS). Methods: Retrospective study of cases of PA/CS-IVS prenatally diagnosed between 20 and 28 weeks and with complete postnatal follow-up. A scoring system based on the diagnostic accuracy of morphological and functional cardiac features was constructed for predicting the postnatal outcome and this was compared with previous predictive models. Results: The study group included 16 liveborn fetuses (9 PA, 7 CS). Twelve fetuses had a BV outcome, and 4, all with PA, had non-BV repair. The mean gestational age at diagnosis was 23.1 ± 3.5 weeks (range, 20-28). The right cardiac dimensions, the ratio between right and left structures and the right ventricular inflow related to the cardiac cycle length were significantly ...