Study on the views and methods of ultrasonic screening and diagnosis for abnormal aortic arch in infants

Abstract

Background The purpose of this study was to explore echocardiographic views and methods of aortic arch anomalies in infants, so as to improve the screening sensitivity and diagnostic accuracy. Methods 140 children with abnormal aortic arch diagnosed by ultrasound in Children’s Hospital of Hebei Province from January 2014 to December 2019 were selected for retrospective analysis. All were confirmed by surgery or/and computerized tomography angiography. Series of views for aortic arch (the three-vessel and tracheal view, aortic arch short axis view, left aortic arch long axis view, aortic arch long axis continuous scan views) were performed in all cases on the basis of the routine views of echocardiography. The screening sensitivity and diagnostic coincidence rate of different echocardiographic views for aortic arch anomalies were analyzed. Results Among the 140 infants, right aortic arch were 21 cases (6/21 were accompanied by mirror branch and 15/21 were with aberrant left subclavian artery). Left aortic arch with aberrant right subclavian artery were 2 cases, and double aortic arch with both arches open were 20 cases. Double aortic arch with left arch atresia were 2 cases, and atresia of the proximal aorta with aortic arch dysplasia was 1 case. Coarctation of the aorta were 67 cases, and interruption of aortic arch were 27 cases. All the patients were correctly diagnosed except that 2 infants with interruption of aortic arch were incorrectly diagnosed as coarctation of the aorta, and 1 infant with coarctation of the aorta was misdiagnosed as interruption of aortic arch by echocardiography. The screening sensitivities of four views and four-view combination for abnormal aortic arch were 99.3, 73.6, 87.1, 99.3, and 100%; the diagnostic coincidence rates were 85.7, 27.1,66.4, 95.0%, and 97.9% respectively. On the basis of traditional left aortic long axis view, other three views had their own advantages. The screening sensitivity and diagnostic coincidence rate of four-view combination were significantly improved. Conclusions The three-vessel trachea view is simple and feasible, which is suitable for screening abnormal aortic arch. The combination of four views conduces to improving screening sensitivity and diagnostic accuracy of aortic arch abnormalities.

Off-pump Aortic Arch Interruption Surgery: Anesthetic Management and Outcomes

“…[18] Preoperative echocardiography is an essential diagnostic technique that aids in ruling out hypertrophy, pericardial effusion, and other disorders in addition to congenital structural heart abnormalities such as ventricular septal defects, aortic valve defects, or mitral valve defects. Gaining a thorough grasp of the patient's cardiac status is essential for creating accurate surgical plans, lowering surgical risks, and increasing surgical success rates [21,22].…”

Ultrasound diagnosis of double aortic arch with atresia: a clinical case

“…Однако из-за ограничения акустического окна и использования только парасагиттальных срезов для визуализации дуги аорты, ЭхоКГ не всегда может быть использована для установления анатомии СК [1,6]. Анатомо-физиологические особенности новорожденных (тонкая передняя грудная клетка, развитая ткань вилочковой железы, менее выраженная степень окостенения грудины) обеспечивают у пациентов данной возрастной категории удовлетворительную визуализацию загрудинных структур при трансторакальном УЗ-сканировании [1,8]. Что позволило получить у нашего пациента специальные проекции, воспроизводимые при поперечном сканировании области верхнего средостения: срез через три сосуда и трахею (3VT) (см.…”

“…рис. 3, а, б), используемый в пренатальной УЗ-диагностике для выявления различных аномалий дуги аорты у плода [8], и проекция высокого поперечного сечения на уровне отхождения брахиоцефальных артерий (см. рис.…”