Prenatal Findings in Total Anomalous Pulmonary Venous Return

Abstract

The diagnosis of TAPVR can be suspected on standard axial views included in second-trimester obstetric screening examinations of the fetal heart and confirmed on fetal echocardiography with the use of pulsed wave Doppler imaging. Clues recognizable on obstetric sonographic screening have the potential to contribute to increasing the diagnostic yield for prenatal detection of TAPVR.

A case of infracardiac total anomalous pulmonary venous return

“…TAPVR is rare, with an incidence of 0.6–1.2 per 10 000 live births . Antenatal diagnosis is restricted by the limited ultrasonographic clues that raise suspicion of possible TAPVR . For this reason, it is crucial to consider critical cardiac lesions in sick newborns despite having a normal antenatal course.…”

Total Anomalous Pulmonary Venous Connection: From Embryology to a Prenatal Ultrasound Diagnostic Update

“…In non-heterotaxy cases, TAPVC can be detected as an isolated anomaly or with other complex heart/great vessel lesions such as atrioventricular septal defect, transposition of the great arteries, pulmonary stenosis, double outlet right ventricle, and coarctation of the aorta. When TAPVC is diagnosed through prenatal echocardiography, a trend of more fetuses accompanied with heterotaxy syndrome or complex CHD and less fetuses with isolated TAPVC has been noted [ 24 ]. TAPVC genetic etiology is remaining vogue and previous study reported some possible disease-driven genes (e.g., ACVRL1, SGCD , 4p13-q12, ANKRD1 , etc.)…”

“…An inability to demonstrate this normal connection is an important sign for suspecting TAPVC. Recent studies have described this as the first clue to suspect the disease [ 7 , 24 ]. A smooth posterior wall of the LA can be viewed as an accessory feature to this abnormal connection of PVs and is observed in some cases.…”

“…The discrepancy in bilateral ventricles is not always observed and tends to be recognized after the gestational age of 7 months [ 24 ]. This is because the flow of pulmonary circulation increases in the latter stage of fetal life.…”

“…In some cases of supracardiac TAPVC, the SVC is either as large as or more prominent than the aorta [ 37 ]. In supracardiac TAPVC, SVC dilatation is more frequently identified than is the extra vertical vein [ 24 ].…”