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Prenatal detection of ductal‐dependent congenital heart disease: how can things be made easier?
Author(s) -
Viñals F.,
Tapia J.,
Giuliano A.
Publication year - 2002
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 - 10.1046/j.1469-0705.2002.00651.x
Subject(s) - ductus arteriosus , medicine , aortic arch , ventricle , pulmonary atresia , cardiology , interrupted aortic arch , fetus , anatomy , heart disease , aorta , pregnancy , biology , genetics
Objective To improve the detection of ductal dependence in fetuses with severe anomalies of the outflow tracts by observing, with directional power Doppler, reverse flow through the aortic arch or ductus arteriosus in a transverse view of the upper mediastinum. Methods A slight cranial move of the ultrasound beam from the three‐vessel view allows the transverse view of the aortic arch and ductus arteriosus to be visualized simultaneously. This view is orthogonal to the fetal body axis and parallel to the plane of the four‐chamber view. In normal fetuses, directional power Doppler interrogation at this level identifies forward flow in both oblique vessels. Results We examined 43 fetuses with cardiac defects. In five of the cases, there was reversed flow in the aortic arch or ductus arteriosus in addition to severe anomalies of the outflow tracts, including four with hypoplastic left ventricle and one with pulmonary atresia. Conclusions Prenatal detection of reversed flow in the aortic arch or ductus arteriosus is associated with complex congenital heart disease with major diminution of forward flow to the corresponding great vessels. Copyright © 2002 ISUOG