Prenatal diagnosis of bilateral ventriculocoronary fistulas with hypoplasia of the left ventricle.

Fetal echocardiography and color Doppler sonography have shown that most heart defects can be reliably diagnosed in utero by associated hemodynamic changes. Congenital ventriculocoronary fistulas associated with hypoplastic right heart syndrome (HRHS) and hypoplastic left heart syndrome (HLHS) have been described in the prenatal and neonatal periods, but little attention has been paid to their incidence and hemodynamic changes. There have been only a few reports of prenatal diagnosis of ventriculocoronary communications in HRHS and HLHS. Here we report prenatal diagnosis of HLHS and fistulas between the left ventricle and both the right and left coronary arteries to the pulmonary artery with a muscular ventricular septal defect (VSD) in a fetus at 23 weeks' gestation.