Fetal Vascular Rings and Pulmonary Slings: Strategies for Two- and Three-Dimensional Echocardiographic Diagnosis

J Am Soc Echocardiogr. 2021 Apr;34(4):336-351. doi: 10.1016/j.echo.2020.10.013. Epub 2020 Nov 6.

Abstract

Fetal aortic arch anomalies and pulmonary slings can be difficult to accurately diagnose but have important clinical implications related to vascular rings, congenital heart disease, and chromosomal anomalies. In this article, the authors briefly review the embryology and development of the fetal arch to facilitate understanding of its diverse variants. Two-dimensional echocardiographic characteristics are summarized for each type of these malformations to propose a strategy for fetal diagnosis. The added benefits of three-dimensional echocardiography with spatiotemporal image correlation are also shown. Finally, the authors propose a strategy for volume acquisition and postanalysis to spur postanalysis clinical use of this technology.

Keywords: Aortic arch anomaly; Echocardiography; Fetus; Pulmonary artery sling; Vascular ring.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aorta, Thoracic / diagnostic imaging
  • Echocardiography
  • Echocardiography, Three-Dimensional*
  • Female
  • Heart Defects, Congenital* / diagnostic imaging
  • Humans
  • Pregnancy
  • Ultrasonography, Prenatal
  • Vascular Ring*