Morphological features of complex congenital cardiovascular anomalies in fetuses: as evaluated by cast models

Wang, Yu; Luan, Hong; Han, Wei; He, Lin; Song, Ben-Cai; Hu, Yunfei; Peng, Yuan; Wang, Bin; Wang, Jing; Huang, Wen-Ying; Deng, Jing; Xie, Mingxing

doi:10.1007/s11596-017-1778-9

Cited by 11 publications

(9 citation statements)

References 35 publications

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“…This method can display the three-dimensional (3D) morphology of fetal severe CHDs. Its unique advantages will help to improve the understanding of fetal cardiac anatomy and the accuracy of prenatal diagnosis 5,6 . This study indicated cast models could vividly reveal the origin, course, dimension and spatial relationship of ductus arteriosus and other great vessels.…”

Section: Discussionmentioning

confidence: 99%

Utility of modified vascular corrosion casting technique in the diagnosis of fetal ductus arteriosus abnormalities

Wang

Zhang

et al. 2020

Sci Rep

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The anatomy of ductus arteriosus (DA) can be varied in different congenital heart defects (CHDs), and it is difficult to fully discover the DA and other associated cardiac anomalies by prenatal ultrasound. This study was aimed to use the modified vascular corrosion casting technique to prepare fetal cardiovascular casts with DA anomalies, assess the casting effectiveness in evaluating the great vessels of the fetal heart and investigate the utility of cardiovascular casting for the demonstration of fetal DA abnormalities. This retrospective study enrolled fourteen fetuses (23 to 28 +2 gestational weeks) with severe CHDs diagnosed by prenatal echocardiography and casting technique from January 2013 to July 2019. The sonographic features of DAs were carefully observed and other associated cardiovascular anomalies were also evaluated during the screening. The architectures of DAs and the whole cardiovascular system were observed and analyzed, and then the cast findings were compared with prenatal ultrasonic results. In fourteen cases, 18 ductal abnormities were indicated by prenatal echocardiography in fourteen cases, while 25 were revealed by casting. Cast findings included 4 cases of ductal stenosis, 1 case of ductal dilation, 6 cases of ductal circuity, 3 cases of right-sided ductus, 5 cases of anomalous ductal connection, 1 case of bilateral ductus and 5 cases of absent ductus. Cast findings consisted with ultrasound in 10 ductal abnormalities, revealed additional 15 ductal abnormalities miss-diagnosed by sonography, and corrected 6 abnormalities misdiagnosed prenatally. Meanwhile, 3 ductal abnormalities (reversed flow) could not be demonstrated by casts but only by ultrasound. Cast models can visually display the anatomical characteristics of ductus arteriosus, and could be successfully used in the demonstration of ductus abnormalities in fetuses with severe CHDs. Comparing with ultrasound, casting technique has its own superiority in exhibiting ductus abnormalities, especially in certain types such as course, origin and absence abnormalities of ductus. Nowadays, fetal cardiac screening has been paid more and more attention 1. As an important physiological channel for fetal circulation, ductus arteriosus, a normal structure connecting pulmonary trunk (PT) with descending aorta (DAo), is playing an indispensable role in fetal cardiovascular system 2,3. Fetal congenital heart defects (CHDs) are often accompanied by ductal abnormalities. In these cases, the connection, course and dimension of the arterial duct can be varied 2-4. Sometimes it is difficult to fully discover the ductal and other associated cardiac anomalies by prenatal ultrasound. Vascular corrosion casting technique is capable of accurately exhibiting the three-dimensional (3D) architecture of cardiovascular system. Our modified cast models can visually display the origin, course, dimension and relative spatial position of the great vessels, and may become an important supplement to prenatal echocardiography 5,6. This study was aimed to introduce th...

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Section: Discussionmentioning

confidence: 99%

Utility of modified vascular corrosion casting technique in the diagnosis of fetal ductus arteriosus abnormalities

Wang

Zhang

et al. 2020

Sci Rep

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“…A vascular corrosion cast is a relatively advanced technique for making anatomical vascular specimens . It can vividly display the actual geometry of the cardiac cavities and vascular lumens, and it is suitable for demonstrating complex congenital cardiovascular malformations. In our study, vascular casting was performed in one case of CPVA (Figure ), which allowed a clear grasp of the complex malformation with a more comprehensive understanding of the three‐dimensional structures than allowed by conventional cardiac autopsy.…”

Section: Discussionmentioning

confidence: 99%

Comparison of prenatal ultrasound and postmortem findings in fetuses with common pulmonary vein atresia

et al. 2019

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Background The previous literature on common pulmonary vein atresia (CPVA) mainly consists of neonatal case reports. There is a lack of research on the prenatal diagnosis of CPVA. Methods We conducted a retrospective study of all fetuses with CPVA confirmed by autopsy between August 2010 and May 2018. Prenatal echocardiographic features, autopsy findings, and genetic test results were analyzed. We compared fetal CPVA with total anomalous pulmonary venous return (TAPVR) and neonatal CPVA. Results During the study period, fetal echocardiography was performed on 31 617 fetuses. Six cases of CPVA were identified by autopsies, including 1 case performed with a cardiovascular cast. All 6 cases (100%) had asplenia syndrome (AS) and bilateral superior vena cava (BSVC). In 1 case (16.7%), the prenatal ultrasound results were in complete agreement with the postmortem findings. Four cases (66.7%) were misdiagnosed as TAPVR by prenatal echocardiography. For the remaining case (16.7%), no pulmonary venous anomalies were detected on prenatal echocardiography. No aneuploidy was identified in any of the cases. There were no statistically significant differences among the proportions of associated complex anomalies and AS between the fetal CPVA and TAPVR groups. The proportion of associated complex anomalies and AS in the fetal CPVA group was higher than that in the neonatal group (P < 0.05). Conclusions Prenatal diagnosis of fetal CPVA is difficult and challenging even for experts. Our study showed that fetal CPVA is often combined with AS, complex cardiac malformations, and BSVC. These findings may help in the diagnosis of fetal CPVA.

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“…In case 3, postnatal echocardiography also confirmed the prenatal diagnosis of a PA sling and other associated cardiac anomalies. In our previous study, we applied cardiovascular casts to display 3‐dimensional anatomy of fetal congenital cardiovascular anomalies . In case 2, not only the cardiac chambers and great vessels but also the trachea were cast with different colors.…”

Section: Discussionmentioning

confidence: 99%

“…In our previous study, we applied cardiovascular casts to display 3-dimensional anatomy of fetal congenital cardiovascular anomalies. 8,9 In case 2, not only the cardiac chambers and great vessels but also the trachea were cast with different colors. The cast vividly showed the interrelationship between the PA branches and trachea.…”

Section: Discussionmentioning

confidence: 99%

Utility of the 3‐Vessel and 3‐Vessel and Trachea Views in Prenatal Diagnosis of a Pulmonary Artery Sling

Peng

Luan

et al. 2018

J of Ultrasound Medicine

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A pulmonary artery (PA) sling is a very rare congenital cardiovascular anomaly, and only a few studies have reported PA slings in fetuses. The relationship of the PA, aorta, ductus arteriosus, and trachea can be evaluated in the 3-vessel and 3-vessel and trachea views during fetal echocardiography. A PA sling can be detected by abnormal positioning of the left PA in relation to the trachea when sweeping from the 3-vessel view cranially to the 3-vessel and trachea view. Here we report 3 cases of fetal PA slings and their follow-ups. Two cases were confirmed by postnatal echocardiography, and the other case was confirmed by a cardiovascular cast after pregnancy termination. We emphasize that the 3-vessel and 3-vessel and trachea views are of crucial importance in the prenatal diagnosis of a PA sling.

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Morphological features of complex congenital cardiovascular anomalies in fetuses: as evaluated by cast models

Cited by 11 publications

References 35 publications

Utility of modified vascular corrosion casting technique in the diagnosis of fetal ductus arteriosus abnormalities

Utility of modified vascular corrosion casting technique in the diagnosis of fetal ductus arteriosus abnormalities

Comparison of prenatal ultrasound and postmortem findings in fetuses with common pulmonary vein atresia

Utility of the 3‐Vessel and 3‐Vessel and Trachea Views in Prenatal Diagnosis of a Pulmonary Artery Sling

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