OP35.06: New echocardiographic characteristics for screening fetuses with isolated total anomalous pulmonary venous drainage

Abstract

Objectives: Currently, detection of isolated total anomalous pulmonary venous drainage (TAPVD) is one of the important issues for fetal heart screening. The purpose of this study is to find the new echocardiographic characteristics in an isolated TAPVD. Methods: We retrospectively reviewed the stored STIC fetal echocardiographic images in 4 fetuses with isolated TAPVD. Two of them were cardiac type (26 and 28 weeks of gestation) and the other 2 were infra-cardiac type (26 and 34 weeks). The minimal distance from the descending aorta (dAo) to the left atrium (LA), and the length of LA posterior wall were measured in the 4-chamber view. The volume of the LA was calculated by vocal analysis using STIC data set. These measurements in the fetuses with TAPVD were compared with those obtained from 50 fetuses with normal cardiac anatomy. Results: The minimal distances from the dAo to the LA were less than 4.0 mm in all fetuses with normal heart, whereas in the fetuses with TAPVD they were more than 6.0 mm (6.1, 6.4, 8.5, and 9.0 mm). The lengths of the LA posterior wall were longer than 20 mm in most of the fetuses with normal hearts, however, in the fetuses with TAPVD they were less than 16 mm. The LA volumes were more than 0.4 cm3 in all fetuses with normal hearts after 26 weeks of gestation, whereas in three fetuses with TAPVD they were 0.17, 0.19, and 0.21 cm3 after 26 weeks of gestation. Conclusions: The fetuses with cardiac or infra-cardiac type TAPVD have long distance from dAo to LA, short length of posterior LA surface, and small volume of LA. All these values around the LA can be obtained easily in a simple 4-chamber view, hence they may be useful checking points to suspect TAPVD while screening fetal hearts.