P32.01: The importance of the three‐vessels and trachea view in fetal heart screening : report of five cases of vascular rings diagnosed in fetal period
Year: 2007
Type: conference-abstract
Abstract: Vascular ring is an aortic arch anomaly. The trachea and esophagus are entrapped by the abnormal aortic arch vessels. Symptoms are breathing and swallowing difficulties, and some cases have severe findings of tracheomalacia. It is extremely difficult to diagnose in the postnatal period because of nonspecific symptoms. On the other hand, in the fetal period, it is easier to check for aortic arch anomaly by use of the three-vessels and trachea (3VT) view. We illustrate the importance of the 3VT view in fetal heart screening by describing five cases of vascular ring. We report five cases of vascular ring, four cases of right aortic arch with aberrant left subclavian artery (RAA with ALSA) and one case of double aortic arch (DAA). These cases were detected in low risk pregnancies by the 3VT view, showing the U-shaped appearance of the great vessels with the trachea. In the DAA case, we also confirmed the findings by the rendering image of the 3D power Doppler ultrasound. Among five cases, one case of RAA with ALSA had the intracardiac anomaly (tetralogy of Fallot : TOF), and the DAA case had the extracardiac anomaly (omphalocele). All cases were not associated with the chromosomal anomaly. In the postnatal period, the infant with DAA showed the most severe symptoms, requiring surgery one month after birth. The child is now one year old, still necessitating the respiratory management with tracheotomy. Among four cases of RAA with ALSA, two infants were symptomatic within one year after birth, and required surgery. In the other two infants, one infant had a preventive operation nine days after birth, and another infant with TOF had no complications, until Blalock-Taussig shunt operation was performed two month after birth. It is one of the great advantages of fetal heart screening to have intrathoracic information, especially around the trachea. The great improvement in fetal heart screening might be achieved by use of the 3VT view.
DOI: 10.1002/uog.4790
Authors: K. T. K. Tsujimura, R. I. R. Izumi, S. I. S. Izumi, M. K. M. Kawataki
Institutions: Tokai University, Kanagawa Children's Medical Center
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2098048846