Pulmonary atresia with ventricular septal defect: multicenter analysis
of prenatal diagnosis cases
A retrospective analysis of 12 cases of prenatal diagnosed of pulmonary atresia with ventricular septum defect (PA-VSD) is presented. In the study of the fetal four chambers view cardiomegaly was detected in 2 (16.7 %) cases. The axis of the heart changed in 8 (66.7 %) cases. Ventricular septal defect (VSD) and overriding dilated ascending aorta were identified in all cases. Central pulmonary arteries were identified in 12 (100%) cases. In 7 (58.3 %) cases the dimensions of the pulmonary arteries were at least 2SD below the mean value for gestational age in the remaining 5 (41.7 %) cases were very narrow. Pulmonary blood supply was prenatally identified as ductus arteriosus (DA) in 8 (66.7 %) and major aortopulmonary collateral arteries (MARSAs) in 3 (25 %) and mixed (DA + MARSAs) in 1 (8.3 %). Fetal hydrops is detected in 2 (16.7 %) cases. The left aortic arch was in 9 (75 %) cases and right aortic arch — 3 (25 %). The average gestational age at prenatal diagnosis was 19.6 (13–23) weeks of gestation. Early diagnosis is represented by one case in 13 weeks of gestation. Еxtracardiac defects were registered in 3 (25 %) cases. Outcomes in fetuses with PA-VSD: termination of pregnancy — 10 (83.4 %), fetal death — 1 (8.3 %), only 1 (8.3 %) survivor