BACKGROUND: Prenatal ventricular size discrepancy with disproportionately smaller left ventricle than right ventricle (L-R/VD) can be a marker for important left-sided structural heart disease in the newborn. METHODS: We reviewed the echocardiograms of all fetuses evaluated at our center with L-R/VD from July 1, 2004 to January 1, 2008. RESULTS: Of the 35 fetuses, 20 (57%) had critical arch obstruction and underwent neonatal intervention (group 1); 15 (43%) did not require newborn intervention (group 2). Ratios comparing left with right heart structures were significantly lower in group 1 fetuses compared with group 2 fetuses. Aortic arch measurement <or= 3 mm was the most sensitive, and abnormal direction of atrial level shunting was the most specific measure to predict the need for neonatal aortic arch intervention. CONCLUSION: Ratios expressing the magnitude of L-R/VD, direction of flow at the atrial septum, and measurements of the aortic arch help identify fetuses that will require neonatal intervention.
BACKGROUND: Prenatal ventricular size discrepancy with disproportionately smaller left ventricle than right ventricle (L-R/VD) can be a marker for important left-sided structural heart disease in the newborn. METHODS: We reviewed the echocardiograms of all fetuses evaluated at our center with L-R/VD from July 1, 2004 to January 1, 2008. RESULTS: Of the 35 fetuses, 20 (57%) had critical arch obstruction and underwent neonatal intervention (group 1); 15 (43%) did not require newborn intervention (group 2). Ratios comparing left with right heart structures were significantly lower in group 1 fetuses compared with group 2 fetuses. Aortic arch measurement <or= 3 mm was the most sensitive, and abnormal direction of atrial level shunting was the most specific measure to predict the need for neonatal aortic arch intervention. CONCLUSION: Ratios expressing the magnitude of L-R/VD, direction of flow at the atrial septum, and measurements of the aortic arch help identify fetuses that will require neonatal intervention.
Authors: Lauren Tague; Mary T Donofrio; Amanda Fulgium; Robert McCarter; Catherine Limperopoulos; David N Schidlow Journal: J Ultrasound Med Date: 2017-06-19 Impact factor: 2.153
Authors: Jonathan H Soslow; Ann Kavanaugh-McHugh; Li Wang; Daniel L Saurers; Neeru Kaushik; Stacy A S Killen; David A Parra Journal: J Am Soc Echocardiogr Date: 2013-09-23 Impact factor: 5.251