Congenital heart diseaseFetal Diagnosis of Interrupted Aortic Arch
Section snippets
Methods
Fetuses and neonates diagnosed with an IAA were ascertained by searching the database of the cardiovascular program at the Children's Hospital Boston (Boston, Massachusetts), using the diagnostic codes for all types of IAA. Patients suspected to have an IAA prenatally who were found to have another diagnosis after birth were also included. The postnatal cohort only included patients who presented to our institution at <1 month of age. Patients with additional major cardiac anomalies who also
Results
From June 1988 through April 2009, 26 fetuses and 56 additional neonates ≤30 days old were diagnosed with an IAA at Children's Hospital Boston. Of the 26 fetuses with a prenatal diagnosis of IAA, 21 were liveborn and 5 families elected to terminate the pregnancy without fetopsy. The median gestational age at diagnosis was 25.7 weeks (range 17.0 to 37.3) overall and 19.8 weeks (range 18.8 to 20.1) for the terminated pregnancies (p <0.001 for comparison of terminated pregnancies with those
Discussion
As with other conotruncal anomalies, the prenatal diagnosis of IAA is relatively uncommon. During the past 21 years at our center, 24% of patients born with an IAA were diagnosed in utero.8, 11, 12 However, during the course of the study, the frequency of the prenatal diagnosis increased from 11% in the first 7-year period to 43% in most recent 7-year period. Despite a high association of chromosomal anomalies and that the outcomes of IAA remain suboptimal,13 the rate of termination was <25%
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Cited by (21)
The Three-Vessel View in the Fetal Mediastinum in the Diagnosis of Interrupted Aortic Arch
2011, Ultrasound in Medicine and BiologyCitation Excerpt :The difference is probably because of the higher mean gestational age in our series—34 weeks compared with 25 weeks. In another series, the PA/Ao ratio was 1.92 at 25 weeks (Vogel et al. 2010). In normal pregnancy, we observed slightly increasing PA/Ao ratio from 1.1 in 20 weeks to 1.2 in 40 weeks (Zalel et al. 2004).
High-definition Power Doppler Ultrasound Facilitates Prenatal Diagnosis of Interrupted Aortic Arch
2011, Journal of Medical UltrasoundCitation Excerpt :A number of anatomic features can facilitate the diagnosis. The most prominent anatomic hallmarks of IAA in the present series were a small aortic valve with a normal-size left ventricle, mildly enlarged right-sided structures, small aortic valve/pulmonary valve and ascending aorta/pulmonary artery diameter ratios, and the universal presence of a VSD, which always has been identified correctly as a posterior malalignment defect in cases of IAA Type B [6]. Moreover, a newer Doppler sonographic technique, known as high-definition flow imaging, was introduced [7].
Usefulness of three vessel-trachea view and parasagittal plan for prenatal diagnosis of interrupted aortic arch
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This study was supported by contributions from the Kenrose Kitchen Table Foundation, Gig Harbor, Washington.