PP-230 The Diagnosis of Fetal Hypoplastic Left Heart

Abstract

The aim of the present case report is to show the characteristics of hypoplastic left heart in fetal ultrasonography. A 23 year old, parity 3 gravidity 2, singleton pregnant women referred to our department with indication of fetal anomaly screening. Anomaly screening for all systems were performed. Evaluation of general features of the fetal hearth (position, size and axis of the hearth), atria, ventricles and atrioventricular valves and evaluation of outflow tracts and three-vessel view additional to basic cardiac examination were also performed. Anomaly screening of the fetus was normal except cardiac screening. In the evaluation of fetal hearth, atria, ventricles and atrioventricular valves, an apparently small left ventricular and atria and dilated right ventricular and atria was detected. In the evaluation of three-vessel view, ascending aorta was absent. In addition, backflow in arcus aorta was detected which confirms the diagnosis of hypoplastic left hearth (Figure 1). The pregnancy was terminated according to parents’ decision and autopsy was not performed. The frequency of hypoplastic left heart is approximately 1% of congenital heart diseases. Left ventricular hypoplasia or atresia, mitral valve hypoplasia or atresia, aortic valve atresia with ascending aorta hypoplasia are the main findings of hypoplastic left heart. The symptoms include postnatal early period cyanosis and dyspnea following the closure of patent ductus arteriosus. Diagnosis primarily depends on postnatal angiocardiography. However, as shown in the present study, a detailed fetal cardiac examination can show hypoplastic left hearth and can give opportunity for postnatal treatment planning in continuing pregnancies.