Prenatal echocardiographic assessment of right aortic arch

Campanale, Cosimo Marco; Pasquini, Luca; Santangelo, Teresa; Iorio, Fiore S.; Bagolan, Pietro; Sanders, Stephen P.; Toscano, Alessandra

doi:10.1002/uog.20098

Cited by 29 publications

(35 citation statements)

References 34 publications

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“…RAA may be present with mirror image branching of a normal left aortic arch, giving rise to the left innominate, right carotid, and right subclavian arteries in sequence. Nevertheless, RAA with aberrant retroesophageal/retrotracheal left subclavian artery (ALSA) forming a vascular ring is also common [ 11 ]. RDA was described in about 10% of cases with RAA [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Postnatal Outcome and Associated Anomalies of Prenatally Diagnosed Right Aortic Arch with Concomitant Right Ductal Arch: A Systematic Review and Meta-Analysis

et al. 2020

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Right aortic arch presents a reported incidence of 0.1% of the general population; the aim of our study was to evaluate the risk of associated intracardiac (ICA), extracardiac (ECA), or chromosomal abnormalities in fetuses with right aortic arch (RAA) and concomitant right ductal arch (RDA). A systematic review of the literature selected 18 studies including 60 cases of RAA/RDA. A meta-analysis with a random effect model calculated for each outcome the pooled crude proportion of associated abnormal outcomes in cases of RAA/RDA and the pooled proportions and odds ratios in RAA with LDA or RDA. Quality assessment of the included studies was achieved using the NIH quality assessment tool for case series studies. RAA/RDA presents risk of associated conotruncal CHDs of about 30% and risk of 22q11 microdeletion in the region of 1%. Two-thirds of 22q11 microdeletions had concomitant thymic hypoplasia and no other chromosomal defects were described. Risks for ICA, ECA, 22q11 microdeletion, and aberrant left subclavian artery are not substantially different in RAA with right or left arterial duct. RAA increases the risk of associated cardiac defects regardless of laterality of the ductal arch. In isolated RDA/RAA cases, absolute risks of extracardiac associated problems or surgery are rather low, we would therefore recommend reassurance, particularly when the thymus and karyotype are normal.

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Section: Introductionmentioning

confidence: 99%

Postnatal Outcome and Associated Anomalies of Prenatally Diagnosed Right Aortic Arch with Concomitant Right Ductal Arch: A Systematic Review and Meta-Analysis

et al. 2020

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“…A right aortic arch is a type of congenital aortic arch anomaly, and the prevalence is estimated to be 0.1% [1]. Among them, a double aortic arch (DAA) is much rarer, affecting approximately 0.005% ~ 0.007% of fetuses [2,3].…”

Section: Introductionmentioning

confidence: 99%

Fetal double aortic arch: prenatal sonographic and postnatal computed tomography angiography features, associated abnormalities and clinical outcomes

Guo

Kong

Zeng

et al. 2020

Preprint

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Background: Fetal double aortic arch (DAA) malformation is a rare congenital heart disease. There is a lack of large sample on comparative study of prenatal ultrasound diagnosis with postnatal computed tomography angiography (CTA) diagnosis, surgery, and autopsy results.Methods: A retrospective cohort study was carried out on cases of fetal DAA that underwent a comprehensive ultrasound examination and were seen during a six-year period at seven tertiary referral centers.Results: A total of 36 cases out of 40 prenatally diagnosed DAA fetuses were confirmed by postnatal diagnosis (fetal autopsy, CTA, and surgery). In this cohort of 36 confirmed cases, 24 (67%) were isolated anomalies, while 12 (33%) were associated with intracardiac or extracardiac anomalies, and 2 (6%) had a 22q11.2 chromosome deletion. There were 9 cases of pregnancy termination with a fetal autopsy. Among the remaining 27 live births, 16 (59%) were asymptomatic and 11 (41%) received surgical treatment due to tracheal or esophageal compression symptoms, all with satisfactory outcomes. Prenatal echocardiography showed that DAA was mainly characterized by a bifurcation of the ascending aorta into the right and left aortic arch and the formation of a complete O-shaped vascular ring around the trachea on the three-vessel tracheal view. A variant in the aortic arch branching pattern was found for the first time. The airway obstruction, branching pattern and atretic arch of DAA were clearly shown by postnatal CTA.Conclusions: Fetal DAA has unique features on prenatal echocardiography and postnatal CTA, and steps and tips for systematic prenatal examination are required. The clinical outcomes of isolated DAA are favorable, even if surgery is performed due to symptoms. Determining whether other malformations or chromosomal anomalies exist is crucial for prognosis evaluation and prenatal decision-making.

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“…The right aortic arch is a congenital vascular anomaly, which may form a vascular ring that causes respiratory failure after birth. [1][2][3][4] However, prenatal identification of the branching pattern of brachiocephalic vessels as shown by conventional two-dimensional echocardiography is often limited. Here, we clearly demonstrated the vascular arrangement in a fetus with right aortic arch with aberrant left subclavian artery using HDlive Flow imaging.…”

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confidence: 99%

“…Among them, right aortic arch with aberrant left subclavian artery and double aortic arch may form a vascular ring that causes respiratory failure. [1][2][3][4] Therefore, a prenatal diagnosis of this vascular arrangement could contribute to optimal care after birth. However, prenatal identification of the branching pattern of brachiocephalic vessels is often limited by acoustic windows and sonographer experience.…”

mentioning

confidence: 99%

“…However, prenatal identification of the branching pattern of brachiocephalic vessels is often limited by acoustic windows and sonographer experience. 2 Recently, several clinical advantages of three-/ four-dimensional ultrasound imaging to diagnose fetal aortic arch anomalies have been reported. [3][4][5] Regarding HDlive Flow imaging, once the volume data are acquired, we could manipulate the data to recreate views that enable identification of the vascular arrangement later.…”

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confidence: 99%

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Right aortic arch with an aberrant left subclavian artery: sonographic features by HDlive Flow imaging

2020

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Prenatal echocardiographic assessment of right aortic arch

Cited by 29 publications

References 34 publications

Postnatal Outcome and Associated Anomalies of Prenatally Diagnosed Right Aortic Arch with Concomitant Right Ductal Arch: A Systematic Review and Meta-Analysis

Postnatal Outcome and Associated Anomalies of Prenatally Diagnosed Right Aortic Arch with Concomitant Right Ductal Arch: A Systematic Review and Meta-Analysis

Fetal double aortic arch: prenatal sonographic and postnatal computed tomography angiography features, associated abnormalities and clinical outcomes

Right aortic arch with an aberrant left subclavian artery: sonographic features by HDlive Flow imaging

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