Tetralogy of Fallot in the fetus: findings at targeted sonography

Yoo, Shi Joon; Lee, Y.-H.; Kim, E. S.; Ryu, Hyun Mee; Kim, M. Y.; Yang, Jae Hyug; Chun, Yong Sung; Hong, Sung Ran

doi:10.1046/j.1469-0705.1999.14010029.x

Cited by 34 publications

(36 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…12,18,19,26,27 Subsequent studies have investigated the roles of these views specifically in prenatal detection of tetralogy of Fallot. 20,21,28,29 Series of 1521, 2028, and 2520 fetuses with tetralogy of Fallot showed frequent abnormal vessel alignment in the 3-vessel or 3-vessel and trachea view, and the aortic arch isthmus typically measured larger than the ductus arteriosus. Our findings are in agreement with these series, demonstrating that the 3-vessel and trachea view, when visualized, was abnormal, with a reversed aortic arch isthmus-to-ductus arteriosus ratio in 100% of fetuses who were confirmed postnatally to have tetralogy of Fallot or a double-outlet right ventricle.…”

Section: Discussionmentioning

confidence: 99%

Role of the 3‐Vessel and Trachea View in Antenatal Detection of Tetralogy of Fallot

Palatnik

Grobman

Cohen

et al. 2016

J of Ultrasound Medicine

View full text Add to dashboard Cite

etralogy of Fallot is the most common form of cyanotic congenital heart disease and accounts for 3% to 5% of all congenital heart diseases. 1 The classic anatomic form of tetralogy of Fallot includes a subaortic ventricular septal defect, an aortic root that overrides the ventricular septal defect, infundibular pulmonary stenosis, and concentric right ventricular hypertrophy, with the last feature developing postnatally. More severe forms include right outflow obstruction such as an absent pulmonary valve and pulmonary atresia. Prenatal diagnosis in cases with severe obstruction provides the opportunity to administer early prostaglandin infusion after delivery to maintain ductal patency, thus avoiding life-threatening cyanosis in the early neonatal period. 2 However, the frequency of in utero diagnosis of tetralogy of Fallot has been reported to be only 32% to 47% and varies between different screening centers. [3][4][5][6][7] The contributing factors to the relatively low frequency of prenatal diagnosis are the frequently normal appearance of the 4-chamber view, poor visualization of the outflows tracts, and delay in the evolution of pulmonary atresia, which may only occur in the third trimester. [8][9][10] Anna Palatnik, MD, William A. Grobman, MD, MBA, Leeber S. Cohen, MD, Jeffrey S. Dungan, MD, Nina L. Gotteiner, MD Received September 17, 2015, CASE SERIESPrenatal diagnosis of tetralogy of Fallot remains less frequent compared to other major congenital heart defects. In this study, we examined how often the 3-vessel and trachea view was abnormal in a large series of prenatally diagnosed cases of tetralogy of Fallot. In addition, we compared its sensitivity to that of the traditional outflow tract views for detection of tetralogy of Fallot. We found that both views were abnormal in all fetuses with tetralogy of Fallot, showing reversed aortic-to-pulmonary valve and aortic arch isthmus-to-ductus arteriosus ratios in the outflow tract and 3-vessel and trachea views, respectively. However, as a single measured marker, the enlarged aortic arch isthmus on the 3-vessel and trachea view appears to be the most sensitive for tetralogy of Fallot.

show abstract

Section: Discussionmentioning

confidence: 99%

Role of the 3‐Vessel and Trachea View in Antenatal Detection of Tetralogy of Fallot

Palatnik

Grobman

Cohen

et al. 2016

J of Ultrasound Medicine

View full text Add to dashboard Cite

show abstract

“…The improvements in routine ultrasound techniques are expected to increase dramatically the number of cases with prenatally detected cardiac defects (15). Prenatal diagnosis of tetralogy of Fallot aids parental counseling and enables the early inhibition of optional treatment at a pediatric cardiac center, which may further improve treatment outcomes (16).…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis of Tetralogy of Fallot Associated with Chromosome 22q11 Deletion

Min

Lee

et al. 2002

J Korean Med Sci

View full text Add to dashboard Cite

Microdeletion of 22q11 is responsible for DiGeorge syndrome, velocardiofacial syndrome, congenital conotruncal heart defects, and related disorders. We report our experiences on prenatal diagnosis by fluorescence in situ hybridization (FISH) for 22q11 deletion in two fetuses with tetralogy of fallot. Karyotyping and FISH of the parents revealed that one fetus inherited the disease from maternal microdeletion. These findings suggest the importance of performing FISH in pregnancies with prenatally detected tetralogy of Fallot.

show abstract

“…[4][5][6][7][8][9][10][11][12][13]18 Extreme levocardia is also associated with CHDs. 19,20 More than 50% of our patients had extreme levocardia.…”

Section: B Amentioning

confidence: 99%

“…[2][3][4][5][6][7] Great artery asymmetry may suggest congenital heart disease. [4][5][6][7][8][9][10][11][12][13] Throughout gestation, the fetal main pulmonary artery (MPA) is normally equal to or slightly larger than the fetal ascending aorta (AA), except occasionally in the early second trimester, when the AA may be slightly larger than the MPA. 2,14,15 Additionally, great artery sizes are preserved in growth-restricted fetuses.…”

mentioning

confidence: 99%

Aorta Larger Than Pulmonary Artery in the Fetal 3‐Vessel View

Rollins

Acherman

Castillo

et al. 2009

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objective. Fetal great artery asymmetry may accompany congenital heart disease. The fetal echocardiographic 3-vessel view (3VV) allows assessment of the superior vena cava, ascending aorta (AA), and main pulmonary artery (MPA). Our aim was to determine the association of congenital heart disease in fetuses with an AA/MPA ratio of greater than 1. Methods. We electronically searched our fetal echocardiographic database for studies performed between March 2002 and January 2008 that showed 3VVs with AA/MPA ratios of greater than 1 and correlated the findings with the presence of congenital heart disease. Results. In 2797 fetal echocardiograms, we identified 31 fetuses with normal 4-chamber views showing AA/MPA ratios of greater than 1 in the 3VV. Of 31 fetuses, 25 (81%) had tetralogy of Fallot (ToF) or a ToF variant, and 6 (19%) had an aortic valve abnormality or isolated dilatation of the AA. Conclusions. Screening obstetric fetal sonography showing a 3VV AA/MPA ratio of greater than 1 suggests congenital heart disease and indicates the need for comprehensive fetal echocardiography.

show abstract

Tetralogy of Fallot in the fetus: findings at targeted sonography

Abstract: The key features of tetralogy of Fallot were always demonstrable in the ventricular outflow tract, three-vessel and short-axis views. The most common reason for referral was the abnormal three-vessel view.

Cited by 34 publications

References 23 publications

Role of the 3‐Vessel and Trachea View in Antenatal Detection of Tetralogy of Fallot

Role of the 3‐Vessel and Trachea View in Antenatal Detection of Tetralogy of Fallot

Prenatal Diagnosis of Tetralogy of Fallot Associated with Chromosome 22q11 Deletion

Aorta Larger Than Pulmonary Artery in the Fetal 3‐Vessel View

Contact Info

Product

Resources

About