Prenatal diagnosis, associated findings and postnatal outcome in fetuses with congenitally corrected transposition of the great arteries

Abstract

Purpose To analyze anatomic features and associated malformations in 37 prenatally detected cases of congenitally corrected transposition of the great arteries (ccTGA) and to evaluate the prenatal course, neonatal outcome and mid-term follow-up. Methods Retrospective analysis of prenatal ultrasound of 37 patients with ccTGA in two tertiary centers between 1999 and 2019. All fetuses received fetal echocardiography and a detailed anomaly scan. Postnatal outcome and follow-up data were retrieved from pediatric reports. Results Isolated ccTGA without associated cardiac anomalies was found in 13.5% (5/37), in all other fetuses additional defects such as VSD (73.0%), pulmonary obstruction (35.1%), tricuspid valve anomalies (18.9%), aortic arch anomalies (13.5%), ventricular hypoplasia (5.4%) or atrioventricular block (5.4%) were present. The rate of extracardiac malformations or chromosomal aberrations was low. There were 91.9% (34/37) live births and postnatal survival rates reached 91.2% in a mean follow-up time of 4.98 years. The prenatal diagnosis of ccTGA was confirmed postnatally in all but one documented live birth and the prenatal counselling regarding the expected treatment after birth (uni- versus biventricular repair) was reassured in the majority of cases. The postnatal intervention rate was high, 64.7% (22/34) received surgery, the intervention-free survival was 36.7%, 35.0% and 25.0% at 1 month, 1 year and 10 years, respectively. Conclusions ccTGA is a rare heart defect often associated with additional heterogeneous cardiac anomalies that can be diagnosed prenatally. The presented study demonstrates a favorable outcome in most cases but the majority of patients require surgical treatment early in life.

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

“…However, the connection between the ventricle and the main artery was abnormal, and D‐TGA was finally diagnosed. In this group, seven cases (23.3%) of cc‐TGA were found, which was consistent with the fact that the cc‐TGA accounted for only 20% of TGA reported in previous literature 8 . TGAs are mainly distinguishable from DORV.…”

“…In this group, seven cases (23.3%) of cc-TGA were found, which was consistent with the fact that the cc-TGA accounted for only 20% of TGA reported in previous literature. 8 TGAs are mainly distinguishable from DORV. Although the aorta and pulmonary artery are arranged in parallel, the aorta straddles Diagnosing TOF and DORV is difficult owing to the lack of specificity in four-chamber views.…”

Prenatal Diagnosis, Associated Findings, and Postnatal Outcome in Fetuses with Double Inlet Ventricle (DIV)

“…With regard to the position of the great vessels and the univentricular situation, ccTGA [14,15] and hypoplasia of the left ventricle [16] are also included as differential diagnostic considerations.…”

Prenatal transposition of great arteries diagnosis and management: a Chinese single-center study

“…A comprehensive assessment by ultrasound, obstetrics, and paediatric cardiac surgeons during pregnancy is crucial for integrated perinatal management. However, most related studies have focused primarily on obstetrics and paediatric cardiac surgery ( 17 , 18 ). Fetal echocardiography has the opportunity to perform more accurate postnatal risk stratification for TGA and provide conditions for the combined integrated diagnosis, treatment and management.…”