Persistent right umbilical vein: a prenatal condition worth mentioning?

Weichert, J.; Hartge, D.R.; Germer, U.; Axt-Fliedner, R; Gembruch, Ulrich

doi:10.1002/uog.7764

Cited by 45 publications

(54 citation statements)

References 46 publications

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“…The incidence of 0.40% (48/12,071) detected in the current study seems to be compatible with the reported incidence of RSLT during neonatal ultrasonography (0.08–0.46%)22, 23, 24, 25, 26, 27, 28 and the prevalence of the condition in the adult population 4, 14, 15, 29. To compare and discuss various observations about the anatomy of the liver, clear definitions and knowledge about basic vascular anatomy are required.…”

Section: Discussionsupporting

confidence: 92%

Biliary architecture of livers exhibiting right-sided ligamentum teres: an indication for preoperative cholangiography prior to major hepatectomy

Nishitai

Shindoh

Yamaoka

et al. 2016

HPB

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ObjectiveTo obtain information about the basic biliary anatomy of livers with right-sided ligamentum teres (RSLT).Summary of background dataRSLT is a relatively rare anomaly with a reported incidence of 0.2–1.2%. Although the portal/hepatic venous and arterial anatomy of livers with RSLT has already been established, the biliary architecture of such livers remains unclear.MethodsRSLT was detected in 48 patients during 12,071 consecutive image readings (0.4%). Of these patients, the cholangiograms of 46 patients were analyzed, and their intrahepatic biliary tree confluence patterns were classified.ResultsThe following four unique biliary confluence patterns were identified in livers with RSLT: the symmetrical type (23/46), independent right lateral type (13/46), total left type (6/46), and total right type (1/46). Analyses of the portal and arterial branching patterns of these livers showed that there were no correlations between their biliary confluence patterns and their portal or arterial ramification patterns.ConclusionThe basic biliary architecture of livers with RSLT was clarified. As the RSLT patients' anomalous biliary confluences differed from those seen in normal livers and were difficult to predict, preoperative cholangiography should be performed prior to complex hepatobiliary surgery involving livers with RSLT to ensure patient safety.

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Section: Discussionsupporting

confidence: 92%

Biliary architecture of livers exhibiting right-sided ligamentum teres: an indication for preoperative cholangiography prior to major hepatectomy

Nishitai

Shindoh

Yamaoka

et al. 2016

HPB

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“…128 Occasionally, the absence of the ductus venosus results in unimpeded placental return because the umbilical vein drains through alternate low-resistance fetal venous pathways, which can lead to significant volume overload and heart failure. 129 The true incidence of fetal venous malformations is undefined, but because of the frequently reported occurrence of cardiac abnormalities, 82 fetal echocardiogram has previously been recommended. Given the existing data, fetal echocardiography may be reasonable to consider in the presence of an umbilical cord or venous abnormality; however, because considerable ascertainment bias may have been introduced in the available studies, usefulness is not well established, especially if obstetric ultrasound is otherwise normal.…”

Section: Abnormalities Of the Umbilical Cord And Venous Systemmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

1,016

543

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Background— The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and management of fetal cardiovascular disease. Methods and Results— A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence for practice guidelines were applied to the current practice of fetal cardiac medicine. Recommendations relating to the specifics of fetal diagnosis, including the timing of referral for study, indications for referral, and experience suggested for performance and interpretation of studies, are presented. The components of a fetal echocardiogram are described in detail, including descriptions of the assessment of cardiac anatomy, cardiac function, and rhythm. Complementary modalities for fetal cardiac assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin–twin transfusion syndrome, lung masses, and vascular tumors, are highlighted. Catheter-based intervention strategies to prevent the progression of disease in utero are also discussed. Recommendations for delivery planning strategies for fetuses with congenital heart disease including models based on classification of disease severity and delivery room treatment will be highlighted. Outcome assessment is reviewed to show the benefit of prenatal diagnosis and management as they affect outcome for babies with congenital heart disease. Conclusions— Fetal cardiac medicine has evolved considerably over the past 2 decades, predominantly in response to advances in imaging technology and innovations in therapies. The diagnosis of cardiac disease in the fetus is mostly made with ultrasound; however, new technologies, including 3- and 4-dimensional echocardiography, magnetic resonance imaging, and fetal electrocardiography and magnetocardiography, are available. Medical and interventional treatments for select diseases and strategies for delivery room care enable stabilization of high-risk fetuses and contribute to improved outcomes. This statement highlights what is currently known and recommended on the basis of evidence and experience in the rapidly advancing and highly specialized field of fetal cardiac care.

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“…Il porte sur la présence de varices de la veine ombilicale, d'une duplication de la vésicule biliaire, d'un kyste hépatique ou d'anomalies de trajet de la veine porte ou de ses branches [414].…”

Section: Diagnostic Différentielunclassified

“…Lors du développement, ces veines sont intégrées dans le foie qui est en expansion rapide et forment des anastomoses avec le plexus capillaire hépatique. Trois variantes sont possibles [414] : cette forme, la veine ombilicale s'abouche soit dans les veines iliaques, soit directement dans l'oreillette droite ou la portion adjacente de la veine cave inférieure. La partie extrahépatique des veines ombilicales va régresser rapidement.…”

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“…À ce moment, le sang des veines ombilicales droite et gauche parvient au sinus veineux d'une part directement, d'autre part à travers les anastomoses hépatiques (voir Figure 6.208). Ces formes extrahépatiques seraient constamment associées à d'autres malformations [414]. Le sang des veines ombilicales n'atteint plus alors le sinus veineux que mélangé avec celui des veines vitellines à travers le foie, et au niveau post-hépatique via la veine vitelline droite lors de la régression de la corne sinusale gauche.…”

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Malformations cardiaques

2013

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Persistent right umbilical vein: a prenatal condition worth mentioning?

Abstract: K E Y W O R D S:

Cited by 45 publications

References 46 publications

Biliary architecture of livers exhibiting right-sided ligamentum teres: an indication for preoperative cholangiography prior to major hepatectomy

Biliary architecture of livers exhibiting right-sided ligamentum teres: an indication for preoperative cholangiography prior to major hepatectomy

Diagnosis and Treatment of Fetal Cardiac Disease

Malformations cardiaques

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