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产前超声心动图诊断法洛四联症合并左肺动脉中断:1例报告并文献复习

Prenatal echocardiographic diagnosis of a discontinuous left pulmonary artery with Taussig-Bing syndrome: a case report and literature review.

作者信息

He Yun, Yang Yufei, Song Xiaoyu, Zhang Zhonglei, Yan Dingfang, Xie Chao, Zeng Min, Zhang Wenjun

机构信息

Department of Ultrasound Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China.

Department of Cardiothoracic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China.

出版信息

Front Pediatr. 2024 Dec 12;12:1437500. doi: 10.3389/fped.2024.1437500. eCollection 2024.

Abstract

BACKGROUND

Unilateral pulmonary artery discontinuity (UPAD) is a rare fetal abnormality, for which a prenatal ultrasonographic diagnosis remains challenging. We report a case of left pulmonary artery discontinuity in association with Taussig-Bing syndrome, which has rarely been reported in the literature thus far.

CASE PRESENTATION

A pregnant woman with a fetus with congenital heart disease (CHD) at 23 weeks gestation was referred to our center. She denied any familial history of genetic disorders in either spouse, and non-invasive prenatal testing (NIPT) also showed a low risk of CHD for the fetus. An ultrasound examination revealed a complex cardiac malformation indicative of left pulmonary artery discontinuity originating from the ductus arteriosus with Taussig-Bing syndrome. The family eventually chose to terminate the pregnancy and agreed to an autopsy, which confirmed that the prenatal echocardiographic diagnosis was correct. In addition, in this report, we review and analyze 17 reported cases of prenatal echocardiographic diagnoses of UPAD.

CONCLUSIONS

UPAD is characterized by discontinuity between the proximal and distal pulmonary arteries, along with a ductal origin of the distal pulmonary artery. A discontinuous pulmonary artery originating from the ductus can be detected on prenatal sonography using ultrasound technology. The aim is to detect malformations earlier and carry out the necessary intervention measures as soon as possible.

摘要

背景

单侧肺动脉中断(UPAD)是一种罕见的胎儿异常,产前超声诊断仍具有挑战性。我们报告一例左肺动脉中断合并陶西格-宾综合征的病例,该病例迄今为止在文献中鲜有报道。

病例介绍

一名妊娠23周、胎儿患有先天性心脏病(CHD)的孕妇被转诊至我们中心。她否认配偶双方有任何遗传性疾病家族史,无创产前检测(NIPT)也显示胎儿患CHD的风险较低。超声检查发现复杂的心脏畸形,提示左肺动脉中断,起源于动脉导管,合并陶西格-宾综合征。家属最终选择终止妊娠并同意进行尸检,尸检证实产前超声心动图诊断正确。此外,在本报告中,我们回顾并分析了17例产前超声心动图诊断UPAD的报道病例。

结论

UPAD的特征是近端和远端肺动脉之间中断,以及远端肺动脉起源于动脉导管。使用超声技术在产前超声检查中可检测到起源于动脉导管的中断肺动脉。目的是尽早发现畸形并尽快采取必要的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3a5/11669521/fe6ab4307b22/fped-12-1437500-g001.jpg

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