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Caliber of the coronary sinus in fetuses with cardiac defects with and without left persistent superior vena cava and in growth‐restricted fetuses with heart‐sparing effect
Author(s) -
Chaoui R.,
Heling K. S.,
Kalache K. D.
Publication year - 2003
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.626
Subject(s) - medicine , persistent left superior vena cava , fetus , coronary sinus , gestational age , cardiology , fetal echocardiography , hypoplastic left heart syndrome , gestation , pregnancy , heart disease , prenatal diagnosis , biology , genetics
Abstract Objective To assess reference ranges for fetal coronary sinus (CS) diameter and to compare them with values from fetuses showing heart defects with and without left superior vena cava (LSVC) as well as with severe intrauterine growth retardation and heart‐sparing effect on color Doppler. Methods The coronary sinus was visualized on two‐dimensional ultrasound in a plane slightly caudal to the apical four‐chamber view. For the normal range of the size of the CS in relation to gestational age, data was collected from 108/114 (95%) normal fetuses with good visualization between 20 weeks' gestation and term. Abnormal conditions comprised two groups: group 1 consisted of 52 fetuses with heart anomalies, including three subgroups: 11 fetuses with isolated LSVC emptying into the coronary sinus, 12 fetuses with LSVC associated with structural heart defects and 29 fetuses with structural heart defects but without LSVC. Group 2 consisted of 11 fetuses with severe intrauterine growth retardation and dilated coronary arteries as seen by color Doppler ultrasound. Results Under normal conditions, there was a significant increase in the CS diameter with advancing gestational age (1.2–2.7 mm). Significant dilatation was found only in the two groups with LSVC (range 2.7–6.5 mm), independent of whether the finding was isolated or associated with cardiac defects. Conclusion CS visualization and measurements are easily feasible in the human fetus in the apical four‐chamber view. Significant dilatation of the CS is a sign of LSVC. The examiner should be aware of this condition as such dilatation is commonly falsely diagnosed as atrial or atrioventricular septal defect. Copyright © 2003 John Wiley & Sons, Ltd.