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Simple approach to prenatal diagnosis of transposition of the great arteries
Author(s) -
Viñals F.,
Ascenzo R.,
Poblete P.,
Comas C.,
Vargas G.,
Giuliano A.
Publication year - 2006
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.2821
Subject(s) - medicine , great arteries , ventricle , ascending aorta , population , aorta , great vessels , fetus , gestational age , radiology , aortic arch , inferior vena cava , fetal echocardiography , prenatal diagnosis , anatomy , cardiology , pregnancy , environmental health , biology , genetics
Objective To analyze the most relevant anomalies, seen in a sequential segmental transverse views approach to imaging the fetal heart, that provide clues to the diagnosis of complete transposition of the great arteries (TGA). Methods We reviewed retrospectively all the cases of isolated TGA diagnosed in our center or submitted for a second opinion through the spatio‐temporal image correlation (STIC) telemedicine (TELE‐STIC) program. Only transverse cardiac sweeps were obtained. Digital video clips and STIC volumes were reviewed. The abnormal features on four‐chamber, five‐chamber, three‐vessel (3V) and three vessels and trachea (3VT) views were analyzed. Results The study population consisted of eight fetuses with TGA with normal extracardiac anatomy. The gestational age ranged from 13 to 32 (mean, 23) weeks. The maternal age ranged from 25 to 42 (mean, 32) years. A normal four‐chamber view was seen in seven cases. Only one case demonstrated a significant ventricular septal defect. At the level of the five‐chamber view a straight course arterial vessel arose from the left ventricle with lateral branches in all fetuses. In the 3V view, the ascending aorta was seen reaching more anteriorly than was the pulmonary artery in six cases. At the level of the 3VT view, two vessels (transverse aortic arch and superior vena cava) rather than three were seen in all cases. Conclusion Our proposed sequential segmental approach to imaging the fetal heart apparently allows, in five‐chamber and 3VT views, clear and confident signs to be detected that aid diagnosis of TGA. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.