Prenatal Diagnosis of Vein of Galen Aneurysmal Malformations

Paternoster, Delia Maria; Manganelli, Francesca; Moroder, W.; Nicolini, Umberto

doi:10.1159/000073133

Cited by 28 publications

(23 citation statements)

References 7 publications

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“…178 It may also occur as a consequence of right heart pathology that leads to an increased volume load to the right heart, including tricuspid 158,159 or pulmonary insufficiency, 160 severe pulmonary outflow obstruction, 220 or ductus arteriosus constriction. 173 Right heart dilation may also be observed in the presence of arteriovenous malformations such as vein of Galen aneurysm 221 or in agenesis of the ductus venosus where umbilical venous return results in preferential streaming to the right heart. 129 Valve and chamber size can be assessed qualitatively or quantitatively.…”

Section: Cardiac Biometrymentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

990

543

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Background— The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and management of fetal cardiovascular disease. Methods and Results— A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence for practice guidelines were applied to the current practice of fetal cardiac medicine. Recommendations relating to the specifics of fetal diagnosis, including the timing of referral for study, indications for referral, and experience suggested for performance and interpretation of studies, are presented. The components of a fetal echocardiogram are described in detail, including descriptions of the assessment of cardiac anatomy, cardiac function, and rhythm. Complementary modalities for fetal cardiac assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin–twin transfusion syndrome, lung masses, and vascular tumors, are highlighted. Catheter-based intervention strategies to prevent the progression of disease in utero are also discussed. Recommendations for delivery planning strategies for fetuses with congenital heart disease including models based on classification of disease severity and delivery room treatment will be highlighted. Outcome assessment is reviewed to show the benefit of prenatal diagnosis and management as they affect outcome for babies with congenital heart disease. Conclusions— Fetal cardiac medicine has evolved considerably over the past 2 decades, predominantly in response to advances in imaging technology and innovations in therapies. The diagnosis of cardiac disease in the fetus is mostly made with ultrasound; however, new technologies, including 3- and 4-dimensional echocardiography, magnetic resonance imaging, and fetal electrocardiography and magnetocardiography, are available. Medical and interventional treatments for select diseases and strategies for delivery room care enable stabilization of high-risk fetuses and contribute to improved outcomes. This statement highlights what is currently known and recommended on the basis of evidence and experience in the rapidly advancing and highly specialized field of fetal cardiac care.

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Section: Cardiac Biometrymentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

990

543

View full text Add to dashboard Cite

show abstract

“…This rare congenital abnormality can cause severe morbidity and mortality-up to 100% in some reports on neonates with heart failure. [9][10][11][12][13][14][15] However, the prenatal natural history of VGAM and its complications is still unclear, and fetal echocardiography can be difficult to assess. Several prenatal findings are considered poor prognostic factors; these include evidence of heart failure (cardiomegaly and tricuspid insufficiency), polyhydramnios, pericardial and pleural effusion, edema and ascites, brain porencephaly, and ventriculomegaly.…”

mentioning

confidence: 99%

Pseudofeeders on fetal magnetic resonance imaging predict outcome in vein of Galen malformations

Saliou

Vraka

Teglas

et al. 2017

Annals of Neurology

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“…Fetal anemia is the most common pathology in this category, and intrauterine transfusions, one of the first successful forms of invasive intrauterine intervention [101,102]. More recently, various groups have explored such therapy for less common lesions associated with high output states including arteriovenous malformations [103][104][105] and acardiac twin gestations [97,106]. From observations made in fetuses with arteriovenous MR1 formations, it has been suggested that when the fetal combined output exceeds nearly 2-fold the normal combined cardiac output the fetus may evolve hydrops or demise [107], an observation which may be applicable to other fetal high output states.…”

Section: Extracardiac Malformations With Cardiac Consequencesmentioning

confidence: 99%

Fetal Echocardiography and Prenatal Cardiovascular Interventions – An Update (2012)

Hornberger

Moon‐Grady²,

Tworetzky³

2012

J Clin Exp Cardiolog

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Fetal echocardiography has evolved considerably over the past 1-2 decades into an exciting field that bridges maternal-fetal medicine with neonatology and pediatric cardiology. With significant advances in imaging technology and experience in prenatal diagnosis, details of the cardiac pathology can now be defined much as it is postnatally; however, unique aspects of the fetal circulation limit our ability to consistently define lesion severity and to predict the evolution of cardiac defects after birth. Serial assessment has provided an understanding of the antenatal natural history of fetal heart disease, which has led to improved counseling and perinatal/neonatal management strategies. More recently, this field has focused on improving our evaluation of fetal arrhythmias, exploring the pathophysiology of fetal heart failure, detecting heart defects at earlier gestational ages, identifying novel interventions to alter the development and progression of severe disease, and investigating strategies to optimize prenatal and neonatal care in an effort to improve perinatal outcome of affected pregnancies. In this paper we will review the current state of the art of fetal/perinatal cardiology and the advances that have occurred in the field largely over the past decade.

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Prenatal Diagnosis of Vein of Galen Aneurysmal Malformations

Cited by 28 publications

References 7 publications

Diagnosis and Treatment of Fetal Cardiac Disease

Diagnosis and Treatment of Fetal Cardiac Disease

Pseudofeeders on fetal magnetic resonance imaging predict outcome in vein of Galen malformations

Fetal Echocardiography and Prenatal Cardiovascular Interventions – An Update (2012)

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