Value of prenatal echocardiography in diagnosis of fetal aorto-pulmonary septal defect

Li Wenxiu; Geng Bin; Wu Jiang; Yang Shuang

doi:10.3760/cma.j.issn.1673-4777.2017.12.006

Abstract：Objective To explore prenatal echocardiographic features of aorto-pulmonary septal defect (APSD).Methods Prenatal echocardiography images of 8 cases of fetal APSD confirmed by echocardiographic and operative results in Pediatric Cardiac Center,Beijing Anzhen Hospital,Capital Medical University from January 2014 to December 2016 were retrospectively reviewed.Echocardiographic features of APSD were analyzed.Results In 8 fetuses with APSD,there were 5 cases of type Ⅱ and 3 cases of type Ⅲ;2 cases were complicated with Berry syndrome;1 case had ventricular septal defect;2 cases had interruption of aortic arch;2 cases had right aortic arch;no extracardiac abnormality was observed.One case with Berry syndrome had induced abortion;6 infants had surgical treatments after birth and recovered well;the other case with Berry syndrome died of recurrent pneumonia and heart failure 63 d after birth without surgical treatments.Characteristics of APSD fetal echocardiogram:①Coronal view of double outflow tract of aorta and pulmonary artery,short-axis view of aorto-pulmonary septum,three-vessel view,three vessels and trachea view showed a communication between pulmonary artery trunk and ascending aorta.②The communication between pulmonary artery and aorta was located before pulmonary artery bifurcation.③The diameter of ascending aorta was wide.④Except Berry syndrome,absence of ductus arteriosus was commonly seen.⑤Color Doppler could show a bidirectional shunt between pulmonary artery trunk and ascending aorta and there was no shunt between ductus arteriosus and ascending aorta.Conclusion Prenatal echocardiography can provide accurate information for diagnosis of fetal APSD,the prognosis of which depends on operation timing and nature of associated cardiac anomalies.