Jiang Huan, Tang Qi, Jiang Yan, Li Ningshan, Tang Xuefeng, Xia Hongmei
Department of Ultrasound, Xinqiao Hospital, Army Medical University, Chongqing, China.
Department of Ultrasound, Kanghua Zhonglian Cardiovascular Hospital, Chongqing, China.
Echocardiography. 2019 Sep;36(9):1736-1743. doi: 10.1111/echo.14452. Epub 2019 Aug 7.
To individually analyze echocardiographic features in fetuses with ductal-dependent congenital heart diseases (DDCHD) and to verify the anatomical characteristics corresponding to the echocardiogram scan views.
Ductal-dependent congenital heart diseases depends on the ductus arteriosus (DA) remaining open to maintain suitable pulmonary or systemic circulation after birth. An accurate diagnosis using prenatal echocardiography has important clinical significance in evaluating disease prognosis and ensuring timely treatment.
Fetuses were followed in the prenatal and postpartum periods via echocardiography. The results of postpartum echocardiography or autopsy specimens were compared with the prenatal echocardiography findings.
One hundred and eight fetuses displayed various types of DDCHD including 66 fetuses with ductal-dependent pulmonary circulation, and 42 fetuses with ductal-dependent systemic circulation. Prenatal echocardiography revealed the typical characteristics of no forward flow signal from right ventricular outflow tract to the pulmonary trunk proximally and a reverse flow in the DA in most fetuses for ductal-dependent pulmonary circulation, a reverse flow in the transverse aortic arch for aorta atresia, and a loss of continuity between aortic arch and descending aorta for interruption of the aortic arch (IAA). All 108 fetuses displayed various types of complex CHD, including right ventricular dysplasia with pulmonary atresia (PA), severe Ebstein anomaly, double outlet right ventricle with PA, tetralogy of fallot with PA, single ventricle with PA or aorta atresia, hypoplastic left heart syndrome, and IAA.
The identification of reverse flow in the aortic arch or DA aids in the subsequent accurate diagnosis of DDCHD associated with complex malformation of the heart.
单独分析依赖动脉导管的先天性心脏病（DDCHD）胎儿的超声心动图特征，并验证与超声心动图扫描视图相对应的解剖学特征。
依赖动脉导管的先天性心脏病依赖动脉导管（DA）保持开放，以在出生后维持适当的肺循环或体循环。产前超声心动图的准确诊断在评估疾病预后和确保及时治疗方面具有重要的临床意义。
通过超声心动图对胎儿进行产前和产后随访。将产后超声心动图结果或尸检标本与产前超声心动图结果进行比较。
108例胎儿表现出各种类型的DDCHD，包括66例依赖动脉导管的肺循环胎儿和42例依赖动脉导管的体循环胎儿。产前超声心动图显示，在大多数依赖动脉导管的肺循环胎儿中，典型特征为右心室流出道至近端肺动脉干无正向血流信号，动脉导管内有反向血流；主动脉闭锁时，横位主动脉弓有反向血流；主动脉弓中断（IAA）时，主动脉弓与降主动脉之间连续性中断。所有108例胎儿均表现出各种类型的复杂性先天性心脏病，包括右心室发育不良合并肺动脉闭锁（PA）、严重埃布斯坦畸形、右心室双出口合并PA、法洛四联症合并PA、单心室合并PA或主动脉闭锁、左心发育不全综合征和IAA。
识别主动脉弓或动脉导管内的反向血流有助于随后准确诊断与心脏复杂畸形相关的DDCHD。
