Prenatal Diagnosis of Double Aortic Arch

Abstract This case report presents a prenatal diagnosis with postnatal confirmation (by angio CT and computer reconstruction) of an isolated double aortic arch, with no blood disturbances and with no clinical symptoms after birth. Literature review was focusing on the possible symptoms in the future. Prenatal findings should be forwarded to neonatologist and pediatrician despite clinical silence.

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Fetal double aortic arch: prenatal sonographic and postnatal computed tomography angiography features, associated abnormalities and clinical outcomes

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03300-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Qiao Guo ◽

Yifan Kong ◽

Shi Zeng ◽

Jiawei Zhou ◽

Xiaofang Wang ◽

...

Keyword(s):

Computed Tomography ◽

Prenatal Diagnosis ◽

Aortic Arch ◽

Clinical Outcomes ◽

Computed Tomography Angiography ◽

Double Aortic Arch ◽

Chromosomal Anomalies ◽

Branching Pattern ◽

Associated Anomalies ◽

Fetal Autopsy

Abstract Background Fetal double aortic arch (DAA) malformation is a rare congenital heart disease with few reported cases in the literature. We aimed to investigate the characteristics of prenatal ultrasound and postnatal computed tomography angiography (CTA) of DAA and to describe the associated anomalies and clinical outcomes to improve prenatal diagnosis and assist in perinatal management. Methods The obstetric ultrasound imaging databases of seven tertiary referral centers were reviewed retrospectively to identify fetuses with a prenatal diagnosis of DAA between January 2013 and December 2018. Ultrasonographic findings, associated anomalies, genetic abnormalities, postnatal CTA images, and long-term postnatal outcomes were evaluated. Results A total of 36 cases out of 40 prenatally diagnosed DAA fetuses were confirmed by postnatal diagnosis (fetal autopsy, CTA, and surgery). In this cohort of 36 confirmed cases, 24 (67%) were isolated anomalies, while 12 (33%) were associated with intracardiac or extracardiac anomalies, and 2 (6%) had a 22q11.2 chromosome deletion. Among nine cases of pregnancy termination with a fetal autopsy, 7 had other abnormalities. Among the remaining 27 live births, 16 (59%) were asymptomatic and 11 (41%) received surgical treatment due to tracheal or esophageal compression symptoms, all with satisfactory outcomes. Prenatal echocardiography showed that DAA was mainly characterized by a bifurcation of the ascending aorta into the right and left aortic arch and the formation of a complete O-shaped vascular ring around the trachea on the three-vessel tracheal view. A variant in the aortic arch branching pattern was found for the first time. The airway obstruction, branching pattern, and atretic arch of DAA were clearly shown by postnatal CTA. Conclusions Fetal DAA has unique features on prenatal echocardiography and postnatal CTA, and systematic prenatal examination and timely postnatal CTA evaluation are required. A certain proportion of intracardiac and extracardiac abnormalities are associated with DAA, but the probability of chromosome abnormalities is low, especially for isolated DAA.The clinical outcomes of isolated DAA are favorable, even if surgery is performed due to symptoms. Determining whether other malformations or chromosomal anomalies exist is crucial for prognosis evaluation and prenatal counseling.

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Fetal double aortic arch: prenatal sonographic and postnatal computed tomography angiography features, associated abnormalities and clinical outcomes

10.21203/rs.3.rs-42144/v2 ◽

2020 ◽

Author(s):

Qiao Guo ◽

Yifan Kong ◽

Shi Zeng ◽

Jiawei Zhou ◽

Xiaofang Wang ◽

...

Keyword(s):

Computed Tomography ◽

Prenatal Diagnosis ◽

Aortic Arch ◽

Clinical Outcomes ◽

Computed Tomography Angiography ◽

Double Aortic Arch ◽

Chromosomal Anomalies ◽

Branching Pattern ◽

Associated Anomalies ◽

Fetal Autopsy

Abstract Background: Fetal double aortic arch (DAA) malformation is a rare congenital heart disease with few reported cases in the literature. We aimed to investigate the characteristics of prenatal ultrasound and postnatal computed tomography angiography (CTA) of DAA and to describe the associated anomalies and clinical outcomes to improve prenatal diagnosis and assist in perinatal management. Methods: The obstetric ultrasound imaging databases of seven tertiary referral centers were reviewed retrospectively to identify fetuses with a prenatal diagnosis of DAA between January 2013 and December 2018. Ultrasonographic findings, associated anomalies, genetic abnormalities, postnatal CTA images, and long-term postnatal outcomes were evaluated. Results: A total of 36 cases out of 40 prenatally diagnosed DAA fetuses were confirmed by postnatal diagnosis (fetal autopsy, CTA, and surgery). In this cohort of 36 confirmed cases, 24 (67%) were isolated anomalies, while 12 (33%) were associated with intracardiac or extracardiac anomalies, and 2 (6%) had a 22q11.2 chromosome deletion. Among nine cases of pregnancy termination with a fetal autopsy, 7 had other abnormalities. Among the remaining 27 live births, 16 (59%) were asymptomatic and 11 (41%) received surgical treatment due to tracheal or esophageal compression symptoms, all with satisfactory outcomes. Prenatal echocardiography showed that DAA was mainly characterized by a bifurcation of the ascending aorta into the right and left aortic arch and the formation of a complete O-shaped vascular ring around the trachea on the three-vessel tracheal view. A variant in the aortic arch branching pattern was found for the first time. The airway obstruction, branching pattern, and atretic arch of DAA were clearly shown by postnatal CTA. Conclusions: Fetal DAA has unique features on prenatal echocardiography and postnatal CTA, and systematic prenatal examination and timely postnatal CTA evaluation are required. A certain proportion of intracardiac and extracardiac abnormalities are associated with DAA, but the probability of chromosome abnormalities is low, especially for isolated DAA.The clinical outcomes of isolated DAA are favorable, even if surgery is performed due to symptoms. Determining whether other malformations or chromosomal anomalies exist is crucial for prognosis evaluation and prenatal counseling.

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OP06.07: Prenatal diagnosis of double aortic arch (DAA): report of 6 cases

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.4451 ◽

2007 ◽

Vol 30 (4) ◽

pp. 473-474

Author(s):

G. Campobasso ◽

P. Volpe ◽

D. Paladini ◽

V. De Robertis ◽

N. Volpe ◽

...

Keyword(s):

Prenatal Diagnosis ◽

Aortic Arch ◽

Double Aortic Arch

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Prenatal diagnosis of double aortic arch and D-transposition of the great arteries: a case report

Prenatal Diagnosis ◽

10.1002/pd.2472 ◽

2010 ◽

Vol 30 (4) ◽

pp. 382-383

Author(s):

W. M. Yao ◽

J. M. Wang ◽

H. F. Huang ◽

Y. H. Ye

Keyword(s):

Case Report ◽

Prenatal Diagnosis ◽

Aortic Arch ◽

Double Aortic Arch

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Prenatal diagnosis of double aortic arch in association with an aortopulmonary window

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez069 ◽

2019 ◽

Vol 20 (10) ◽

pp. 1180-1180

Author(s):

Diana Bernal Quintero ◽

Nicky Manning ◽

Joanne Wolfenden ◽

Marina L Hughes ◽

Jan Marek

Keyword(s):

Prenatal Diagnosis ◽

Aortic Arch ◽

Double Aortic Arch ◽

Aortopulmonary Window

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Early Prenatal Diagnosis of Double Aortic Arch: Prevalence, Associated Anomalies and Outcome

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-1132-5402 ◽

2020 ◽

Author(s):

Osnat Zmora ◽

Ron Beloosesky ◽

Nizar Khatib ◽

Yuval Ginsberg ◽

Asad Khoury ◽

...

Keyword(s):

Prenatal Diagnosis ◽

Aortic Arch ◽

Early Pregnancy ◽

Retrospective Cohort ◽

First Trimester ◽

Double Aortic Arch ◽

Associated Anomalies ◽

Genetic Abnormalities ◽

Postnatal Outcome

Abstract Purpose Our aims were to describe the feasibility of diagnosis of DAA in early pregnancy and to assess its prenatal prevalence, associated anomalies and outcome. Materials and Methods A retrospective cohort review of all DAA cases diagnosed by early prenatal transvaginal scans at 12–17 weeks of gestation between the years 2007–2018 was performed. Associated anomalies, genetic abnormalities and long-term postnatal outcome were evaluated. Results 12 cases of DAA were diagnosed by early prenatal transvaginal scans at a median of 15 (range: 12–17) weeks of gestation out of a total of 28 654 early scans preformed with a prevalence of at least 1:2378. Associated anomalies/genetic abnormalities were found in 5/12 (42 %) cases. The diagnosis was confirmed postnatally in all newborns. In two cases termination of pregnancy was performed. Four patients (40 %) were symptomatic. Six patients (60 %) underwent surgery due to symptoms or due to severe obstruction on imaging with resolution of symptoms in all except one patient. Conclusion DAA can be readily diagnosed transvaginally even in the first trimester. Its prevalence is 1:2387. A search for associated anomalies and genetic abnormalities should be performed. If DAA is isolated, the prognosis with or without surgery is usually good.

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Prenatal diagnosis of tetralogy of Fallot with a double aortic arch

Cardiology in the Young ◽

10.1017/s1047951116000329 ◽

2016 ◽

Vol 26 (5) ◽

pp. 973-975 ◽

Cited By ~ 1

Author(s):

Andrew L. Cheng ◽

Jay D. Pruetz ◽

Grace C. Kung

Keyword(s):

Prenatal Diagnosis ◽

Aortic Arch ◽

Tetralogy Of Fallot ◽

Transthoracic Echocardiography ◽

Cardiac Mri ◽

Fetal Echocardiography ◽

Double Aortic Arch

AbstractIn this study, we present a case of prenatally diagnosed tetralogy of Fallot with a double aortic arch, correlating images from fetal echocardiography, transthoracic echocardiography, and cardiac MRI.

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