Prenatal diagnosis of isolated tricuspid valve dysplasia by echocardiography / 中华超声影像学杂志

ABSTRACT

Objective:To improve the prenatal recognition and diagnostic accuracy of isolated tricuspid valve dysplasia (TVD) by analyzing fetal echocardiographic features.Methods:The fetal echocardiographic features of 7 cases with prenatal diagnosis of TVD were analyzed retrospectively in Pediatric Cardiovascular Center, Beijing Anzhen Hospital, Capital Medical University and Children′s Hospital of Shanxi from June 2012 to December 2020. The fetal echocardiographic characteristics of TVD were summarized.Results:Among the 7 fetuses with TVD, 6 cases showed functional pulmonary atresia with intact ventricular septum and different degrees of pulmonary valve regurgitation, and 1 case showed slightly narrowed pulmonary artery. Characteristic sonographical findings included ①The axis of heart was exaggerated left-axis deviation and the ratio of cardiothoracic was obviously increased. The right heart was enlarged, in which the right atrium was significantly dilated (an important feature of TVD). ②The position of tricuspid valve ring was normal, the attachment point of each leaf was normal, some tricuspid valves were thickened and insufficiency. ③It was common to be complicated with functional pulmonary valve atresia with intact ventricular septum or severe pulmonary valve stenosis. ④Color Doppler imaging showed severe tricuspid regurgitation and the regurgitation velocity was less than 350 cm/s (an important feature of TVD). ⑤In fetus with functional pulmonary valve atresia with intact ventricular septum, color Doppler imaging showed retrograded ductal flow across the pulmonary artery and the different degrees regurgitation of pulmonary valve.Conclusions:Fetal TVD has typical echocardiographic features, mainly including large tricuspid regurgitation and significant enlargement of the right atrium. The prognosis of fetus with functional pulmonary atresia is poor. Early diagnosis plays a crucial role in prenatal consultation and prognosis evaluation.