Prenatal diagnosis of transposition of the great arteries: an updated review

Abstract

Simple transposition of the great arteries (TGA) is a cyanotic heart disease that accounts for 5% to 7% of all congenital heart diseases. It is commonly underdiagnosed in utero, with prenatal detection rates of less than 50%. Simple TGA is characterized by ventriculoarterial discordance, atrioventricular concordance, and a parallel relationship of TGA. The prenatal diagnosis of TGA influences postnatal outcomes and therefore requires planned delivery and perinatal management. For these reasons, it is important to identify the key ultrasound markers of TGA to improve the prenatal diagnosis and consequently provide perinatal assistance. The presence of two vessels instead of three in the three-vessel tracheal view, a parallel course of TGA, and identification of the origin of each of TGA are the key markers for diagnosing TGA. In addition to the classical ultrasound signs, other two-dimensional ultrasound markers such as an abnormal right convexity of the aorta, an I-shaped aorta, and the "boomerang sign" may also be used to diagnose TGA in the prenatal period. When accessible, an automatic approach using fourdimensional technologies such as spatio-temporal image correlation and sonographically-based volume computer-aided analysis may improve the prenatal diagnosis of TGA. This study aimed to review the ultrasound markers that can be used in the antenatal diagnosis of TGA, with a focus on the tools used by ultrasonographers, the obstetric and fetal medicine team, and perinatal cardiologists to improve the diagnosis of this condition.

Effect of Chronic Heart Failure Complicated with Type 2 Diabetes Mellitus on Cognitive Function in the Elderly

“…Chronic heart failure (CHF) is a serious stage in which hypertension, coronary heart disease, cardiomyopathy, and other cardiovascular diseases develop to the end stage [1,2], which is mainly caused by cardiac pumping dysfunction, and has the characteristics of complex, chronic, recurrent attacks, and so on [3][4][5]. CHF often occurs among the middle-aged and elderly [6].…”

The Prenatal Diagnosis~ What should we do? What can we do?

“…In genetic testing, cell-free DNA testing such as NIPT or NIPS has enabled non-invasive risk assessment for common fetal aneuploidies [4,5]. For structural testing, ultrasound scanning is now routinely performed at 18-20 weeks of gestation [2].…”

“…Advances in sonographic techniques have enabled the detection of heart anomalies and/or hydrops in the fetus [2] and the advanced resolution of magnetic resonance imaging (MRI) enables the detection of anomalies on the surface as well as those of internal organs [3]. Genetic testing techniques have fundamentally changed the practice of prenatal diagnosis in the recent decades [4].…”

Antenatal diagnosis of congenital heart disease by 3D ultrasonography using spatiotemporal image correlation with HDlive Flow and HDlive Flow silhouette rendering modes

“…30 ). After birth, patients with TGA usually undergo a cardiac intervention during the neonatal period, and the prenatal diagnosis of TGA is crucial [ 27 ].…”