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1.
Echocardiography ; 41(2): e15788, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38400626

RESUMO

Three-dimensional virtual dissection using high-definition live tissue rendering ultrasound tool of a 23-week gestation fetus with situs solitus, mirror image dextrocardia, ventricular septal defect, aortic override, and pulmonary atresia.


Assuntos
Dextrocardia , Cardiopatias Congênitas , Comunicação Interventricular , Humanos , Dextrocardia/complicações , Dextrocardia/diagnóstico por imagem , Aorta/anormalidades , Feto
2.
Echocardiography ; 41(1): e15743, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38284679

RESUMO

BACKGROUND: Isolated redundant foramen ovale flap aneurysm (RFOA) in the absence of restrictive foramen ovale is believed to be a cause for pseudocoarctation of aorta since the impediment of blood flow to the left heart can be severe, resembling the picture of left ventricular hypoplasia with retrograde aortic flow. The primary objective of the study is to find whether RFOA is always a benign lesion. The main focus of the study is to share my experience in particular on fetuses having redundant foramen ovale flap aneurysm developing into coarctation of aorta and to study the associated factors. METHODS: Retrospective study (January 2020 to June 2023). All fetuses with RFOA associated with and without congenital heart defects were included. Fetuses with restrictive foramen ovale and RFOA with single ventricle hearts were excluded. The imaging, in-utero hemodynamics, pregnancy, and postnatal outcomes with at least 3 months follow-up were presented. RESULTS: During the study period, a total of 1499 fetal echocardiography were performed. Twenty-two fetuses with RFOA were included. Fourteen fetuses had isolated RFOA and eight had associated abnormalities [extracardiac (n = 5); intracardiac (n = 2), Both (n = 1)]. Genetic evaluation were performed only in fetuses with associated defects were normal. Postnatally all isolated RFOA fetuses had no aortic arch obstruction. Fetuses with associated aberrant right subclavian artery, isolated left superior vena cava, absent ductus venosus and ventricular septal defects developed aortic arch obstruction after birth. RFOA causes smallish left ventricle in fetuses with tetralogy of Fallot which recovered to normal size postnatally. CONCLUSION: Isolated RFOA can be benign, however, if it is associated with cardiac or extracardiac anomalies predominantly resulted in aortic arch obstruction. Though it is a cause for pseudocoarctation of aorta, through postnatal reassessment of aortic arch is mandatory. Careful search for intracardiac and systemic venous anomalies is recommended. It created confusion regarding adequacy of left ventricle when associated with congenital heart defects.


Assuntos
Aneurisma , Forame Oval , Cardiopatias Congênitas , Gravidez , Feminino , Humanos , Estudos Retrospectivos , Veia Cava Superior , Ultrassonografia Pré-Natal , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/diagnóstico por imagem , Diagnóstico Pré-Natal , Coração Fetal/diagnóstico por imagem , Hemodinâmica
3.
Cardiol Young ; 34(2): 459-461, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38167265

RESUMO

Myxomatous degeneration of one or more cardiac valves has been reported in trisomy 18, Noonan, Marfan, and Ehlers-Danlos syndromes. 6q25.1 (TAB2) deletion is one of the notable causes for myxomatous degeneration of cardiac valves. Whole exome sequencing must be considered in these subsets of cases for effective prenatal counselling. A 23-week fetus presented with cardiomegaly, redundant myxomatous tricuspid, mitral valve leaflets, thickened pulmonary valve, and bicuspid aortic valves detected to have 6q25.1 (TAB2) deletion was presented with literature review.


Assuntos
Síndrome de Ehlers-Danlos , Valva Pulmonar , Humanos , Proteínas Adaptadoras de Transdução de Sinal , Feto , Valva Mitral
4.
J Ultrasound Med ; 43(3): 609-616, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38050801

RESUMO

Advances in fetal echocardiography including newer techniques like 4D spatio-temporal image correlation technology has improved our understanding of fetal cardiac and extracardiac abnormalities. High resolution ultrasound combined with color Doppler and 3D rendering have contributed to an improved understanding of the fetal vascular system and its anomalies. This pictorial essay including ultrasound images and videos alongside their respective clay models, provides precise information of duct anatomy in fetuses with pulmonary atresia and aortic arch abnormalities.


Assuntos
Permeabilidade do Canal Arterial , Canal Arterial , Cardiopatias Congênitas , Atresia Pulmonar , Gravidez , Feminino , Humanos , Canal Arterial/diagnóstico por imagem , Aorta Torácica/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos
7.
Echocardiography ; 40(4): 376-378, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36943892

RESUMO

Prenatal diagnosis of superior sinus venosus defect has never been reported in the literature. I describe here an echocardiographic sign which is helpful in diagnosing this defect in a 35 + 2 weeks fetus and its rare association with coarctation of aorta.


Assuntos
Coartação Aórtica , Comunicação Interatrial , Veias Pulmonares , Feminino , Humanos , Gravidez , Coartação Aórtica/diagnóstico por imagem , Veia Cava Superior/diagnóstico por imagem , Veias Pulmonares/diagnóstico por imagem , Ecocardiografia , Feto
8.
Echocardiography ; 40(1): 15-29, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36468658

RESUMO

BACKGROUND: Recent advances in fetal ultrasound imaging, especially four-dimensional (4D) spatio-temporal image correlation techniques permit detailed evaluation of the fetal venous system and its abnormalities. In this report, we present the clinical presentation, conventional/4D spatio-temporal image correlation imaging findings, pregnancy, and early postnatal outcomes in fetuses having anomalies of systemic venous return in the absence of significant intracardiac defects from two centres in southern India. OBJECTIVES: To report the clinical presentation, conventional/4D spatio-temporal image correlation imaging findings, pregnancy, and early postnatal outcomes in fetuses having anomalies of systemic venous return in the absence of significant intracardiac defects from two centres in Southern India. METHODS: Retrospective study (October 2017 to March 2022). All fetuses referred with abnormal cardiac imaging findings who were diagnosed to have anomalies of systemic venous return in the absence of significant intracardiac defects were included. Imaging techniques like 2D with color and 4D spatio-temporal image correlation fetal imaging were used to evaluate systemic venous anomalies. Systemic venous anomalies were grouped into cardinal venous anomalies and umbilico-portosystemic venous anomalies. RESULTS: Thirty-nine fetuses were included; this represented 4.4% of all cardiac anomalies diagnosed during the study period. Cardinal venous anomalies were seen in 29 fetuses (74%); the mean gestation age at diagnosis was 25.5 ± 3.4 weeks. Absent dilated coronary sinus was associated with anomalous drainage of superior caval vein through completely unroofed coronary sinus into the left atrium (n = 3) which resulted in cyanosis after birth in all infants. Among the three cases, one underwent surgery at 6 months of age due to a progressive increase in cyanosis (Spo2 78%) and others are awaiting surgery. A prenatal genetic evaluation was performed in 17 (58.6%). Cardinal venous anomalies were not associated with genetic abnormalities. Live births occurred in all fetuses with cardinal venous anomalies. Umbilico-portosystemic venous anomalies were seen in 10 (26%). The mean gestation age at diagnosis was 26.5 ± 4.5 weeks. Except in a fetus with the extrahepatic portosystemic shunt (umbilical vein to iliac vein), the genetic evaluation was normal in our cohort. Extracardiac anomalies (n = 3/10; 30%) were seen in both intra (n = 1) and extrahepatic portosystemic shunts (n = 2). CONCLUSION: Anomalies of systemic venous return in the absence of significant intracardiac, extracardiac, and genetic abnormalities carried an overall favorable prognosis in our cohort. Precise characterization of anatomic details using advanced imaging techniques helps in the understanding of this complex three-dimensional anatomy and in the prognostication of these anomalies.


Assuntos
Cardiopatias Congênitas , Veia Cava Superior , Gravidez , Feminino , Humanos , Lactente , Estudos Retrospectivos , Feto/irrigação sanguínea , Cardiopatias Congênitas/diagnóstico por imagem , Diagnóstico Pré-Natal , Ultrassonografia Pré-Natal
9.
Ann Pediatr Cardiol ; 15(1): 67-69, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35847395

RESUMO

Tachy-bradycardia syndrome (TBS) has been reported rarely in the fetus. We present here an unusual dominant involvement of sinoatrial node in a fetus presenting with TBS of anti-Sjögren'syndrome-related antigen A (SS-A) and antigen B (SS-B) autoantibodies positive mother. Prenatal imaging findings, Doppler hemodynamics, and outcomes are described.

10.
Fetal Pediatr Pathol ; 41(2): 346-350, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32815432

RESUMO

BackgroundFetal echocardiography continues to be the first line investigation for detecting congenital heart diseases (CHD). As accurate and complete diagnosis of complex heart disease is often difficult in the first trimester due to small size of the fetal heart, confirmation/expanded description by fetopsy provides the best information for accurate counseling for future pregnancies. Although non invasive fetal autopsy alternatives have been investigated with favorable results, conventional autopsy remains the gold standard procedure used to confirm the fetal abnormalities. Case report: We describe a conotruncal anomaly diagnosed at 12 weeks gestation using spatiotemporal image. The fetopsy confirmed the diagnosis of Type I Truncus arteriosus. Conclusion: Four-dimensional STIC imaging provides incremental benefits in evaluation of fetal cardiac anomalies, and confirmation by autopsy findings allows further refinement of the diagnosis.


Assuntos
Ecocardiografia Quadridimensional , Cardiopatias Congênitas , Autopsia , Ecocardiografia Quadridimensional/métodos , Feminino , Cardiopatias Congênitas/diagnóstico por imagem , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Diagnóstico Pré-Natal , Ultrassonografia Pré-Natal/métodos
11.
Echocardiography ; 39(1): 157-161, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34923663

RESUMO

Chorioangiomas are the most common non-trophoblastic benign vascular tumor of the placenta, highly associated with perinatal death rate. Herewith, we are reporting the prenatal diagnosis, management and postnatal outcome of a fetus referred at 33 weeks gestation with massive cardiomegaly secondary to placenta chorioangioma.


Assuntos
Hemangioma , Doenças Placentárias , Cardiomegalia/complicações , Feminino , Feto/patologia , Hemangioma/diagnóstico , Hemangioma/diagnóstico por imagem , Humanos , Placenta/patologia , Doenças Placentárias/diagnóstico por imagem , Doenças Placentárias/patologia , Gravidez , Diagnóstico Pré-Natal , Ultrassonografia Pré-Natal
12.
Ann Pediatr Cardiol ; 14(3): 422-427, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34667421

RESUMO

This report describes two cases of tachycardia-induced cardiomyopathy secondary to incessant ectopic atrial tachycardia (EAT) in an infant presenting with severe left ventricular dysfunction and hemodynamic instability. The two cases were managed differently. The first required mechanical ventilation and was resistant to conventional antiarrhythmic drugs. After the initiation of enteral ivabradine (0.15mg/kg) the heart rate slowed with significant improvement in hemodynamics, peripheral perfusion and sinus rhythm was restored after 12 hours. Ivabradine was continued and the patient was discharged home after 10 days of hospitalization. The second case was managed by early initiation of ivabradine and resulted in restoration of sinus rhythm within 4 hours, thus avoiding trials of conventional anti-arrhythmic drugs with unstable hemodynamic profile. The infant was discharged after 5 days of hospitalization on ivabradine..

13.
Cardiol Young ; 31(12): 2041-2044, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34027850

RESUMO

We describe two cases of an unusual variant of double outlet right ventricle with intact ventricular septum diagnosed prenatally and confirmed by foetal autopsy in a case. The first case had mitral valve atresia, slit-like left ventricle, and normally related great arteries. The second case had mitral valve atresia, hypoplastic left ventricle, parallel outflows with an interrupted aortic arch.


Assuntos
Dupla Via de Saída do Ventrículo Direito , Cardiopatias Congênitas , Septo Interventricular , Dupla Via de Saída do Ventrículo Direito/diagnóstico por imagem , Dupla Via de Saída do Ventrículo Direito/cirurgia , Feminino , Feto , Ventrículos do Coração/diagnóstico por imagem , Humanos , Gravidez , Diagnóstico Pré-Natal , Septo Interventricular/diagnóstico por imagem
14.
Echocardiography ; 38(3): 473-479, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33619790

RESUMO

First described in 1965 by Johnson and Wilcox, partial absence of the tricuspid valve (TV) associated with a ventricular septal defect (VSD) is a very rare malformation (Ann Surg. 1966;164:334-336). Heart failure secondary to severe TV regurgitation results in utero fetal compromise (J Am Coll Cardiol. 1991;17:167). We present here a fetus with partial absence of the tricuspid valve with perimembranous VSD.


Assuntos
Insuficiência Cardíaca , Comunicação Interventricular , Insuficiência da Valva Tricúspide , Feminino , Comunicação Interventricular/diagnóstico por imagem , Humanos , Gravidez , Diagnóstico Pré-Natal , Valva Tricúspide/diagnóstico por imagem , Insuficiência da Valva Tricúspide/diagnóstico por imagem
16.
J Med Ultrasound ; 29(4): 284-287, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35127410

RESUMO

We report a case of a huge congenital pulmonary airway malformation (CPAM) that was referred as congenital diaphragmatic hernia (CDH). Initial ultrasound evaluation revealed a huge cystic lesion with septations, in the thorax, causing mediastinal shift and compression effects, suggesting the possibility of a thoracic lymphangioma, or bowel herniation with obstruction. A fetal magnetic resonance imaging reported possible bowel herniation through a posterior defect in the diaphragm, with volvulus, reinforcing the diagnosis of CDH. It was only on autopsy and subsequent histopathology examination that the diagnosis of a rare variant of CPAM-nonmucinous papillary type, could be made. To the best of our knowledge, a CPAM this huge has not been reported prenatally at this gestation. We recommend considering the potential diagnosis of CPAM in any thoracic cystic irrespective of its size or appearance.

19.
Echocardiography ; 37(11): 1880-1882, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33099807

RESUMO

Aortic atresia is uncommonly associated with atrioventricular and ventriculoarterial discordance. Presence of severe regurgitation of Ebstein malformation of the tricuspid valve in this subset results in reduced aortic blood flow in-utero. We report here a term neonate with this anomaly detected antenatally.


Assuntos
Doenças da Aorta , Anomalia de Ebstein , Insuficiência da Valva Tricúspide , Aorta , Anomalia de Ebstein/complicações , Anomalia de Ebstein/diagnóstico por imagem , Humanos , Recém-Nascido , Valva Tricúspide/diagnóstico por imagem
20.
Ann Pediatr Cardiol ; 13(2): 167-170, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32641894

RESUMO

We report a case of right isomerism with a complex congenital heart disease associated with hiatus hernia in a 19-week-old fetus with relevant review of literature. This report highlights the importance of having a proper checklist for prenatal identification of extracardiac manifestations of isomerism syndromes. This will enable us to provide an effective family-centered counseling for perinatal management of these complex lesions. To our knowledge, prenatal sonographic detection of a sliding hiatal hernia in a fetus with right isomerism has not been reported previously.

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