Brompton Centre for Fetal Cardiology, Royal Brompton and Harefield Hospitals, London, UK.
Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK.
Ultrasound Obstet Gynecol. 2022 Nov;60(5):640-645. doi: 10.1002/uog.24966.
To describe the associated cardiac and extracardiac findings and estimate the prevalence of single left superior vena cava (LSVC) among fetuses referred for fetal echocardiography.
This was a retrospective case series of fetuses diagnosed with situs solitus and single LSVC at the Brompton Centre for Fetal Cardiology, London, UK, from October 2006 to December 2020. Prenatal and postnatal outcome data were collected. Prenatal diagnosis was based on abnormal vessel alignment at the three-vessel view and/or three-vessel-and-trachea view, showing a vessel to the left of the pulmonary artery (i.e. the LSVC) and absence of the usual vessel to the right of the ascending aorta (i.e. the right superior vena cava), and further visualization of the LSVC draining into the coronary sinus.
Of 19 968 fetal echocardiograms performed during the study period, 34 cases of single LSVC were identified (a prevalence of 0.17%). Of these, 32 pregnancies had a live birth, one was lost to follow-up and one resulted in intrauterine demise. Single LSVC was isolated in 79.4% of cases. No major congenital heart disease was identified. One fetus showed mild isthmus hypoplasia, with no aortic coarctation postnatally. Two fetuses had umbilical vessel abnormalities. A genetic abnormality was found in one case (15q24.1-q24.2 deletion).
Antenatal diagnosis of single LSVC in the setting of situs solitus is usually a benign isolated finding. Nevertheless, investigation of other cardiac, extracardiac and genetic disorders should be considered. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
描述相关的心脏和心脏外表现，并估计在因胎儿超声心动图就诊的胎儿中，单支左上腔静脉（LSVC）的发生率。
这是一项回顾性病例系列研究，纳入了 2006 年 10 月至 2020 年 12 月在英国伦敦 Brompton 胎儿心脏中心诊断为心脏右位、单支 LSVC 的胎儿。收集了产前和产后结局数据。产前诊断基于三血管切面和（或）三血管-气管切面的异常血管排列，显示肺动脉左侧有一支血管（即 LSVC），而升主动脉右侧通常无血管（即右上腔静脉），并进一步显示 LSVC 引流至冠状窦。
在研究期间进行的 19968 例胎儿超声心动图中，发现 34 例单支 LSVC（发生率为 0.17%）。其中，32 例妊娠分娩活产，1 例失访，1 例宫内死亡。79.4%的病例为孤立性单支 LSVC。未发现重大先天性心脏病。1 例胎儿出现轻度峡部发育不良，但产后无主动脉缩窄。2 例胎儿存在脐血管异常。1 例存在遗传异常（15q24.1-q24.2 缺失）。
在心脏右位的情况下，产前诊断单支 LSVC 通常是良性的孤立性发现。然而，应考虑对其他心脏、心脏外和遗传疾病进行检查。© 2022 作者。超声在妇产科由 John Wiley & Sons Ltd 代表国际妇产科超声学会出版。
