Shima Yoshio, Nakajima Mizue, Kumasaka Sakae, Migita Makoto
Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
Arch Gynecol Obstet. 2009 Apr;279(4):557-9. doi: 10.1007/s00404-008-0739-8. Epub 2008 Aug 8.
Congenitally corrected transposition of the great arteries (ccTGA) is a rare cardiac defect characterized by the atria connecting with anatomically discordant ventricles and the ventricles connecting with discordant and transposed great arteries, which allows hemodynamic compensation. Most patients with ccTGA have associated intracardiac anomalies, which could be a diagnostic clue, whereas isolated forms are infrequently diagnosed during the neonatal period and in utero. We describe a fetus that was diagnosed with ccTGA and without additional cardiac anomalies at 25 weeks of gestation. The parallel course of the great arteries discovered during a routine obstetric scan indicated this rare cardiac anomaly. Further detailed examination of the ventricular morphology helped to confirm the diagnosis. Despite hemodynamic compensation, the long-term prognosis of ccTGA is uncertain because of the possible development of arrhythmias or heart failure later in life. Our findings showed that fetal echocardiography can detect prenatal ccTGA.
先天性矫正型大动脉转位(ccTGA)是一种罕见的心脏缺陷,其特征为心房与解剖结构不匹配的心室相连,心室与不匹配且转位的大动脉相连,从而实现血流动力学代偿。大多数ccTGA患者伴有心内异常,这可能是诊断线索,而孤立型在新生儿期和子宫内很少被诊断出来。我们描述了一名在妊娠25周时被诊断为ccTGA且无其他心脏异常的胎儿。在常规产科扫描中发现的大动脉平行走行提示了这种罕见的心脏异常。对心室形态的进一步详细检查有助于确诊。尽管有血流动力学代偿,但由于后期生活中可能发生心律失常或心力衰竭,ccTGA的长期预后仍不确定。我们的研究结果表明,胎儿超声心动图可在产前检测出ccTGA。