Accuracy and impact of prenatal diagnosis of common arterial trunk

Laux, Daniéla; Derridj, Neil; Stirnemann, J.; Lucron, Hugues; Stos, Bertrand; Lévy, Marilyne; Houyel, Lucile; Bonnet, Damien

doi:10.1002/uog.24873

Cited by 6 publications

(8 citation statements)

References 38 publications

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“…The probability of DORV is believed to be high when the aortic riding rate is ≥75%. Among the 32 PTA cases, the A1 and A2 types were the most common (81.3%), which is consistent with previous literature reports 9 . The STIC imaging technique was used in all cases; the display rate was 50.2%.…”

Section: Discussionsupporting

confidence: 88%

Prenatal diagnosis of fetal conotruncal defects by using 2D ultrasound and HD live flow combined with spatiotemporal image correlation

et al. 2023

J of Clinical Ultrasound

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IntroductionTo explore the diagnostic value of spatiotemporal image correlation (STIC) for different types of fetal conotruncal defects (CTDs).MethodsThe clinical data and STIC images of 174 fetuses with CTDs diagnosed via prenatal ultrasound were analyzed retrospectively.ResultsAmong the 174 cases of CTDs, 58 were tetralogy of Fallot (TOF); 30, transposition of great arteries (TGA) (D‐TGA, 23 cases; cc‐TGA, 7 cases); 26, double outlet of the right ventricle (DORV); 32, persistent arterial trunk (PTA) (type A1, 15 cases; type A2, 11 cases; type A3, 5 cases; type A4, 1 case); and 28, pulmonary atresia (PA) (ventricular septal defect, 24 cases; ventricular septal integrity, 4 cases). Among the cases, 156 were complicated with complex congenital intracardiac and extracardiac malformations. The abnormal display rate of the four‐chamber view of two‐dimensional echocardiography was low. The display rate of the permanent arterial trunk was the highest (90.6%) in STIC imaging.ConclusionsSTIC imaging can be used in the diagnosis of different types of CTDs, especially in persistent arterial trunks, and thus has great value for the clinical treatment and prognosis of these defects.

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Section: Discussionsupporting

confidence: 88%

Prenatal diagnosis of fetal conotruncal defects by using 2D ultrasound and HD live flow combined with spatiotemporal image correlation

et al. 2023

J of Clinical Ultrasound

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“…Moreover, our study shows an excellent agreement between prenatal and postnatal outcomes, with 90.9% of cases being confirmed as CAT and 84% with complete agreement including the subtype as per Van Praagh's and Collet and Edwards' classifications. These figures are similar to those described by groups of experts ranging between 70% and 96% [20,21,23] and better than others where an accurate diagnosis can be as low as 35% [14] reinforcing the need for management in referral centers where experienced examiners with high-quality equipment may achieve the best diagnostic results.…”

Section: Diagnostic Accuracysupporting

confidence: 83%

“…1). For the purpose of this research, stenosis was considered a dichotomic diagnosis and considered present when Doppler velocity through the truncal valve exceeded 1.9 m/s as defined in other studies [20][21][22].…”

Section: Managementmentioning

confidence: 99%

Common Arterial Trunk in Fetal Life: Accuracy of Diagnosis and Prediction of Outcome

Villalaín¹,

Gómez-Montes²,

Felipe³

et al. 2022

Fetal Diagn Ther

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Introduction Common arterial trunk (CAT) is a congenital heart disease with significant perinatal mortality in which diagnostic agreement remains low. Methods Retrospective cohort study on fetuses with suspected CAT. Diagnostic accuracy was tested considering gold-standard postnatal ultrasound or necropsy. Prenatal sonographic markers were evaluated by logistic regression for perinatal survival. Results There were 79 fetuses with suspected CAT, and 55 cases had available necropsy/postnatal ultrasound conforming the study population. The diagnostic accuracy was 90.9% for CAT and 83.6% at a subtype level. In those with a confirmed diagnosis and intention-to-treat (n=28) composite early-mortality (intrauterine, pre-surgical and early-surgery) was of 25%, 10.5% in isolated-cases. The OR for early-mortality of isolated-cases was 0.13 [95% confidence interval (CI) 0.03-0.75]. After adjusting for isolated-cases, the only prognostic prenatal markers of perinatal mortality were a dysplastic truncal valve OR 7.78 (95% CI 1.23-49.13) and a stenotic flow OR 8.48 (95%CI 1.40-51.10) Conclusion CAT is a condition that if evaluated by experts, can be diagnosed with a high degree of accuracy. It remains an entity with high perinatal mortality. Its most important prognostic factor is its association with other anomalies. In isolated cases, the presence of a dysplastic truncal valve and a stenotic flow increase the chances of perinatal death.

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“…Among 88 fetuses with CAT in this study, the incidence of the A1 and A2 types was higher (89.77%), which was consistent with a previous study. 2 Among them, 16 cases (18.18%) were isolated CAT, and the remainder were combined with complex intra-cardiac and extra-cardiac structural deformities.…”

Section: Discussionmentioning

confidence: 99%

Clinical value of prenatal ultrasound in diagnosis and classification of common arterial trunk

et al. 2023

J of Clinical Ultrasound

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ObjectivesTo investigate the clinical value of prenatal ultrasound in the diagnosis of the common arterial trunk (CAT) classification and associated malformations.Materials and MethodsThe 2D ultrasound images, spatiotemporal image correlations (STICs) and clinical data of 88 fetuses diagnosed with CAT malformations by prenatal ultrasound were retrospectively analyzed and classified. The correlation between different types, fetal malformation and pregnancy outcomes were analyzed.ResultsAmong the 88 fetuses, there were 39 cases (44.32%) of type A1, 40 cases (45.45%) of type A2, 8 cases (9.09%) of type A3, and 1 case of type A4 (1.14%). There were 16 cases (18.18%) with isolated CAT, 48 cases (54.55%) with complex intra‐cardiac structural abnormalities, and 24 cases (27.27%) with intra‐cardiac and extra‐cardiac structural abnormalities. In extra‐cardiac structural malformations, 14 cases were associated with 1 other system abnormality, 4 cases with 2 other system abnormalities, 3 cases with 3 other system abnormalities, while 3 cases were combined with 4 other system abnormalities, among which the facial and physical abnormalities had the highest incidence (39.13%). The STIC images were completely displayed in all 88 cases. There was a statistical difference between isolated CAT and CAT combined with other abnormalities in fetal pregnancy outcomes.ConclusionsPrenatal ultrasound had a high clinical application value in CAT classification. Pregnancy outcomes were highly correlated with the classification and associated intra‐cardiac and extra‐cardiac structural malformations. The early evaluation of fetal prognosis before birth has important value for clinical intervention.

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Accuracy and impact of prenatal diagnosis of common arterial trunk

Cited by 6 publications

References 38 publications

Prenatal diagnosis of fetal conotruncal defects by using 2D ultrasound and HD live flow combined with spatiotemporal image correlation

Prenatal diagnosis of fetal conotruncal defects by using 2D ultrasound and HD live flow combined with spatiotemporal image correlation

Common Arterial Trunk in Fetal Life: Accuracy of Diagnosis and Prediction of Outcome

Clinical value of prenatal ultrasound in diagnosis and classification of common arterial trunk

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