scholarly journals Strategies for Diagnosis of Fetal right atrium dilation: Based on fetal cardiac anatomy and hemodynamics

2020 ◽  
Author(s):  
Yu Wang ◽  
Leisheng Zhao ◽  
Ying Zhang
Keyword(s):  
Right Atrium ◽  
Pulmonary Valve ◽  
Peak Velocity ◽  
Pressure Overload ◽  
Volume Overload ◽  
Accurate Diagnosis ◽  
Cardiac Anatomy ◽  
Pulmonary Valve Stenosis ◽  
Chamber View ◽  
Physiological Group

Abstract Background: Fetal right atrium (RA) dilation is frequently detected in routine screenings while it remains a challenge to clarify the reasons. This study aimed to analyze the cardiac anatomy and hemodynamics of fetal RA dilation and the changes of hemodynamic indexes. Methods: In the retrospective study, 420 fetuses with RA dilation were included, which were classified into the physiological group (n=202), volume overload group (n=142), and the pressure overload group (n=76). The ratio of right atrium to left atrium (RA/LA) were measured at four-chamber view. Peak velocity of tricuspid regurgitation (VTR) was recorded in each case, if existed. Results: The RA/LA ratio in the volume overload group is significantly higher than both the pressure overload group and the physiological group (both P=0.000) throughout the pregnancy while no difference presents between the pressure overload group and the physiological group (P=0.694 for 19-31 GW, and P=0.974 for 32-36 GW, respectively). The VTR in the pressure overload group (3.29±0.58 m/s) is significantly higher than both the volume overload group (1.85±0.45 m/s, P=0.000) and the physiological group (0.88±0.45 m/s, P=0.000). The volume overload group shows a significantly higher VTR than the physiological group (P=0.000). In the volume overload group, the ductal contraction/closure shows a significantly higher VTR than that in the pulmonary valve stenosis/atresia (3.98±0.41 m/s vs. 3.03±0.38 m/s, P=0.000).Conclusions: A strategy proposed herein is useful to clarify the reasons for RA dilatation by systematically assessing fetal hemodynamics, which may facilitate the sonographers to make an accurate diagnosis of CHD.

scholarly journals Strategies for Diagnosis of Fetal right atrium dilation: Based on fetal cardiac anatomy and hemodynamics

2020 ◽  
Author(s):  
Leisheng Zhao ◽  
Yu Wang ◽  
Ying Zhang
Keyword(s):  
Right Atrium ◽  
Statistical Significance ◽  
Ductus Arteriosus ◽  
Pressure Overload ◽  
Reference Value ◽  
Volume Overload ◽  
Right Atrial ◽  
Cardiac Anatomy ◽  
Group A ◽  
Group B

Abstract Background Fetal right atrium (RA) dilation is frequently detected in routine screenings while it remains a challenge to clarify the reasons. This study aimed to analyze the cardiac anatomy and hemodynamics of fetal RA dilation and the changes of hemodynamic indexes. Methods 420 fetuses with RA dilation were included, which were classified into 4 types: volume overload (Group A, n=117), pressure overload (Group B, n=85), Ebstein’s anomaly (Group C, n=16), and physiological enlargement (Group D, n=202). All the types was divided into two control groups according to different gestational weeks (19-31 gestational weeks and 32-36 gestational weeks). The ratio of RA and left atrium (RA/LA) were measured at Four-chamber view (4CV) . Peak velocity of tricuspid regurgitation (V TR ) was recorded in each diseases. Results RA/LA in 19-31GW were: A: 1.45±0.24, B: 1.28±0.15, C: 1.22±0.10, D: 1.28±0.18. RA/LA in 32-36GW were: A: 1.68±0.25, B: 1.46±0.23, C: 1.64±0.19, D: 1.45±0.27. V TR in Group B (3.29±0.58 m/s) was higher than that in Group A (1.85±0.49 m/s), C (1.86±0.22 m/s), and D (0.88±0.45 m/s), respectively. As for V TR, there was statistical significance among the ductus arteriosus anomalies (3.98±0.41 m/s), the pulmonary artery anomalies (3.03±0.38 m/s) and the restrictive FO (2.23±0.30 m/s) (all P<0.05). Conclusions We proposed a protocol by which fetal cardiac anatomy and hemodynamics was used to clarify the reasons of fetal RA dilation. We compared the degree of right atrial enlargement in different types of diseases. We also provided a reference value of V TR for each type of reasons of RA dilation.

scholarly journals Does Larger Fetal Ascending Aorta Than the Pulmonary Artery Indicate Major Cardiac Anomaly?

2020 ◽  
pp. 1
Author(s):  
Safak Yilmaz Baran ◽  
Alev Arslan ◽  
Gulsen Dogan Durdag ◽  
Hakan Kalayci ◽  
Seda Yuksel Simsek ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Pulmonary Valve ◽  
Main Pulmonary Artery ◽  
Double Outlet Right Ventricle ◽  
Ascending Aorta ◽  
Pulmonary Valve Stenosis ◽  
Chamber View ◽  
Aorta Diameter ◽  
Pulmonary Artery Diameter

<p><strong>OBJECTIVE:</strong> This study investigated the cases in which the fetal ascending aorta is larger than the main pulmonary artery on the three-vessel view and aimed to determine the relationship between the larger ascending aorta and major cardiac anomalies.</p><p><strong>STUDY DESIGN:</strong> Pregnancies between 18-24 gestational weeks who underwent detailed second-trimester screening during 2015-2019 were evaluated. Cases whose fetal ascending aorta diameter was larger than fetal main pulmonary artery diameter on the three-vessel view despite normal four-chamber view were analyzed. Prenatal and postnatal echocardiography studies were performed for each case.</p><p><strong>RESULTS:</strong> Fetal ascending aorta diameter larger than fetal main pulmonary artery diameter on the three-vessel view despite normal four-chamber view was detected in 21 fetuses in a total of 3810 pregnancies (0.55%), and 10 (47.6%) of them had major congenital heart disease. The diagnosis of Tetralogy of Fallot, double outlet right ventricle, ventricular septal defect, pulmonary valve stenosis, and moderate to severe tricuspid regurgitation were confirmed with prenatal/postnatal echocardiography studies. The highest ratio of ascending aorta/main pulmonary artery was 1.4 in a fetus with a double outlet right ventricle and pulmonary valve stenosis.</p><p><strong>CONCLUSION:</strong> The fetal ratio of ascending aorta/main pulmonary artery larger than 1 on the three-vessel view may be a sign of certain cardiac anomalies. Nevertheless, this rate is not an indicator of a serious cardiac defect in all cases. Fetal advanced echocardiography and early postnatal cardiac evaluation should be done to confirm the diagnosis.</p>

Transcatheter Floating Valve Syndrome in Recurrent Congenital Pulmonary Valve Stenosis

2021 ◽  
Vol 5 (sup1) ◽  
pp. 40-40
Author(s):  
Niko De Angel ◽  
Pranav Loyalka ◽  
Umamahesh Rangasetty ◽  
Syed Gilani ◽  
Melissa Taylor ◽  
...  
Keyword(s):  
Pulmonary Valve ◽  
Pulmonary Valve Stenosis

scholarly journals Regional shape, global function and mechanics in right ventricular volume and pressure overload conditions: a three-dimensional echocardiography study

2021 ◽  
Author(s):  
Jurate Bidviene ◽  
Denisa Muraru ◽  
Francesco Maffessanti ◽  
Egle Ereminiene ◽  
Attila Kovács ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Interventricular Septum ◽  
Three Dimensional ◽  
Pressure Overload ◽  
Volume Overload ◽  
Ventricular Volume ◽  
Longitudinal Contraction ◽  
Convex Shape ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

AbstractOur aim was to assess the regional right ventricular (RV) shape changes in pressure and volume overload conditions and their relations with RV function and mechanics. The end-diastolic and end-systolic RV endocardial surfaces were analyzed with three-dimensional echocardiography (3DE) in 33 patients with RV volume overload (rToF), 31 patients with RV pressure overload (PH), and 60 controls. The mean curvature of the RV inflow (RVIT) and outflow (RVOT) tracts, RV apex and body (both divided into free wall (FW) and septum) were measured. Zero curvature defined a flat surface, whereas positive or negative curvature indicated convexity or concavity, respectively. The longitudinal and radial RV wall motions were also obtained. rToF and PH patients had flatter FW (body and apex) and RVIT, more convex interventricular septum (body and apex) and RVOT than controls. rToF demonstrated a less bulging interventricular septum at end-systole than PH patients, resulting in a more convex shape of the RVFW (r = − 0.701, p < 0.0001), and worse RV longitudinal contraction (r = − 0.397, p = 0.02). PH patients showed flatter RVFW apex at end-systole compared to rToF (p < 0.01). In both groups, a flatter RVFW apex was associated with worse radial RV contraction (r = 0.362 in rToF, r = 0.482 in PH at end-diastole, and r = 0.555 in rToF, r = 0.379 in PH at end-systole, respectively). In PH group, the impairment of radial contraction was also related to flatter RVIT (r = 0.407) and more convex RVOT (r = − 0.525) at end-systole (p < 0.05). In conclusion, different loading conditions are associated to specific RV curvature changes, that are related to longitudinal and radial RV dysfunction.

scholarly journals Outcomes of percutaneous balloon pulmonary valvuloplasty in congenital pulmonary valve stenosis

2021 ◽  
Vol 9 (9) ◽  
Author(s):  
Dan Yin ◽  
Xiaoyun Wu ◽  
Ping Xiang ◽  
Yu Zhang ◽  
Jie Tian ◽  
...  
Keyword(s):  
Pulmonary Valve ◽  
Pulmonary Valve Stenosis ◽  
Percutaneous Balloon

Diagnosis and natural history of isolated congenital pulmonary regurgitation in fetal life

2000 ◽  
Vol 10 (2) ◽  
pp. 162-165 ◽  
Author(s):  
Kazuhiro Mori ◽  
Yasunobu Hayabuchi ◽  
Yasuhiro Kuroda
Keyword(s):  
Conservative Therapy ◽  
Pulmonary Valve ◽  
Fetal Echocardiography ◽  
Pulmonary Regurgitation ◽  
Volume Overload ◽  
Ventricular Volume ◽  
Fetal Life ◽  
History Of ◽  
Dysplastic Pulmonary Valve ◽  
Rare Instance

AbstractWe describe a rare instance of isolated pulmonary regurgitation caused by a dysplastic pulmonary valve which was detected prenatally. Fetal echocardiography demonstrated severe pulmonary regurgitation, and progressive cardiomegaly because of right ventricular volume overload. After birth, conservative therapy was successful in alleviating the pulmonary vascular resistance, and the pulmonary regurgitation gradually decreased.

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