Prenatal echocardiographic diagnosis and differential diagnosis of fetal double outlet left ventricle

Abstract

Objective To investigate the clinical value of prenatal diagnosis of fetal double outlet ventricle. Methods The data of double outlet ventricle from fetal echocardiography in Second Xiangya Hospital of Central South University and Changde Women and Children Health Hospital of Hunan Province from January 2000 to August 2018 were collected. The statistical method was used to analyze characteristics of echocardiography, related-intracardiac and extracardiac abnormalities, postnatal echocardiography, surgery and autopsy findings. Results Ninety-four fetuses were diagnosed with double outlet ventricle, including 84 cases of double outlet right ventricle(DORV) and 10 cases of double outlet left ventricle(DOLV). The pregnancy was terminated in 45 cases. Autopsy was offered to all patients after termination of pregnancy, 42 cases were consistent with prenatal diagnosis, 1 case was tetralogy of fallot, 2 cases were transposition of great artery. Forty-nine cases were decided to continue the pregnancy, 32 cases of them were confirmed by postpartum surgery, 17 cases were confirmed by postnatal echocardiography. Echocardiographic findings of fetal double outlet ventricle was characterized by the origin of the both great arteries arising predominantly or completely(>50%) from the same ventricle. Conclusions Prenatal ultrasound diagnosis of double outlet ventricular has important clinical value, facilitate appropriate prenatal counseling and postnatal management and it should be differentiated with transposition of the great arteries, tetralogy of fallot and ventricular septal defect. Key words: Ultrasonography; Fetus; Prenatal diagnosis; Double outlet ventricular; Congenital heart disease; Cardiac operation