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

Peng, Yuan; Li, Yuman; Luan, Hong; Wang, Yu; Xie, Mingxing

doi:10.1002/jum.14721

Cited by 8 publications

(10 citation statements)

References 11 publications

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“…[6][7][8] In these previously reported cases, 7 out of 13 (% 54) had an abnormal cardiac axis, position, and/or echogenic lungs which resulted in further imaging before and after birth. 3,4,10 In 4 out of 13 cases (% 30), structural heart diseases have been reported. 3,4,10 In 4 out of 13 cases (% 30), structural heart diseases have been reported.…”

Section: Discussion and Con Clus I Onmentioning

confidence: 99%

“…To date, there are a few case reports of prenatal diagnosis of LPAS in the literature [3][4][5][6][7][8][9][10] (Table 1). The prenatal features of 4 additional cases have been described retrospectively after a postnatal diagnosis of LPAS was made by MRI or CT imaging.…”

Section: Discussion and Con Clus I Onmentioning

confidence: 99%

“…3,[5][6][7][8] Only three out of thirteen cases are isolated and have no cardiac and extra cardiac findings on fetal echocardiography examination. 3,4,10 In 4 out of 13 cases (% 30), structural heart diseases have been reported. 6,7,9,10 In the case of LPAS, left pulmonary artery arises from right The features of our case were that there were not any cardiac or extra cardiac abnormalities, and the LPAS was isolated.…”

Section: Discussion and Con Clus I Onmentioning

confidence: 99%

“…3,4,10 In 4 out of 13 cases (% 30), structural heart diseases have been reported. 6,7,9,10 In the case of LPAS, left pulmonary artery arises from right The features of our case were that there were not any cardiac or extra cardiac abnormalities, and the LPAS was isolated. In addition to that, our case was a twin (monochorionic-diamniotic) pregnant woman and there was a discordant malformation.…”

Section: Discussion and Con Clus I Onmentioning

confidence: 99%

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Prenatal diagnosis of left pulmonary artery sling and review of literature

et al. 2019

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Left pulmonary artery sling (LPAS) is a very rare cause of large airway compression. In LPAS, the left pulmonary artery (LPA) arises from the proximal right pulmonary artery, coursing over the right mainstem bronchus, posterior to the trachea and anterior to the esophagus prior to reaching the left hilum. The aberrant course of the LPA results in anatomical obstruction of the right mainstem bronchus, the trachea, or both. Thirty percent of affected patients have major associated structural heart disease 1 which can importantly impact clinical outcome. 2 The clinical manifestation of LPAS after birth usually relates to the severity of airway obstruction and the associated cardiac pathology. Only a few reports present the prenatal features of LPAS. In the present report, we present the prenatal diagnosis of a case of LPAS in one of a set of identical twins in which the only feature was that of an abnormal course of the LPA on 3-vessel tracheal view. | C A S E PRE S ENTATI ONA 30-year-old primigravida woman at 27 weeks' gestation was referred to our maternal fetal medicine unit given the presence of a set of monochorionic, diamniotic spontaneous twins. A full anatomical ultrasound examination performed in both fetuses demonstrated no pathology, and fetal echocardiography demonstrated no major structural heart disease in one twin. In the other twin, fetal echocardiography revealed on a 3-vessel tracheal view that the LPA originated from the right pulmonary artery, originating initially to the right side of the trachea, and turning sharply to course between the trachea and esophagus prior to joining the left hilum (Figure 1, Movie S1). The examination was performed transabdominally using a Voluson E 6 (GE healthcare Ultrasound, Milwaukee, WI, USA) ultrasound machine equipped with a RAB 6D (2-7 MHz) probe. With these findings, pediatric cardiology counseling was offered and LPAS was suspected. The remainder of the cardiac anatomy was Left pulmonary artery sling (LPAS) is a very rare cause of large airway compression.In LPAS, the left pulmonary artery (LPA) arises from the proximal right pulmonary artery, coursing over the right mainstem bronchus, posterior to the trachea and anterior to the esophagus prior to reaching the left hilum. The aberrant course of the LPA results in anatomical obstruction of the right mainstem bronchus, the trachea, or both. Only a few reports present the prenatal features of LPAS. In this report, we present the prenatal diagnosis of a case of LPAS in one of a set of identical twins in which the only feature was that of an abnormal course of the LPA on 3-vessel tracheal view. The cross-sectional view at the level of three vessels which includes both pulmonary artery branches is useful to detect this abnormality. Color and power Doppler may be helpful as well. K E Y W O R D Sfetal echocardiography, left pulmonary artery, vascular imaging

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Section: Discussion and Con Clus I Onmentioning

confidence: 99%

Section: Discussion and Con Clus I Onmentioning

confidence: 99%

Section: Discussion and Con Clus I Onmentioning

confidence: 99%

Section: Discussion and Con Clus I Onmentioning

confidence: 99%

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Prenatal diagnosis of left pulmonary artery sling and review of literature

et al. 2019

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“…Owing to the relative rarity of this condition, the true incidence and frequency of PAS globally is not known. According to a study by Yu et al of 186 213 school‐age children by ultrasound examination, the incidence of PAS is 5.9/100 000. In severely affected infants, death may occur in the first few months of life.…”

Section: Discussionmentioning

confidence: 99%

Prenatal ultrasound diagnosis of fetal isolated right ventricular noncompaction with pulmonary artery sling: A rare case report

et al. 2019

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Noncompaction of the ventricular myocardium (NVM) is a cardiomyopathy characterized by abnormally enlarged intraventricular trabeculae and intersecting deep recesses. It is believed that the failure of reticular trabeculae compaction during early embryonic development plays an important role in the disease. Cavernous cardiomyopathy often involves the left ventricle, while right ventricle and bilateral ventricles are rare. Although there have been several studies on NVM in children and adults, there are few studies on fe-tuses. NVM can occur independently or in combination with other complex cardiac malformations. 1,2 In our case, a rare pulmonary artery sling was also found. The clinical course and prognosis of PAS mainly depend on the degree of airway stenosis. It is generally believed that the high mortality rate of PAS is due to the compression of the tracheobronchial tree rather than PAS itself. Two-thirds of the patients develop symptoms associated with airway diseases in the first month of life. PAS easily escapes detection in its early stages. If untreated, the first-year mortality rate could be approximately 90%.Therefore, precise prenatal diagnosis could be beneficial to its clinical treatment and prognosis. 3,4 Fetal echocardiography is the preferred method for diagnosing fetal cardiomyopathy and other cardiac malformations due to its noninvasive, safe, and inexpensive characteristics. It can provide reliable imaging diagnosis for prenatal consultation of pregnant women. 5 Our report demonstrated that IRVNC associated with PAS can be diagnosed in fetal life by prenatal ultrasound. | C A S E REP ORTA 31-year-old pregnant woman (gravida 2, para 1) was referred to our maternal-fetal medical center at 30 + 5 weeks for suspected heart defects. Her nuchal translucency test and prenatal cell-free fetal DNA testing were both felt to be low-risk. She reported no family history. Fetal echocardiography showed the right atrium and ventricle were markedly dilated, a maximum right ventricular wall thickness of 7.5 mm, and multiple prominent trabeculations and deep intertrabecular recesses communicating with the right ventricular cavity (Figure 1). Both the LV and RV function were normal.The left pulmonary artery anomalously originates from a normally positioned right pulmonary artery and running posterior to the trachea, forming a PAS. Color Doppler Flow Imaging (CDFI) revealed that there was a right-to-left blood flow signal in the foramen ovale, AbstractNoncompaction of the ventricular myocardium (NVM), also known as spongy myocardium, is a rare type of cardiomyopathy that has a serious impact on fetuses, children, and adults. NVM mainly affects the left ventricle, as isolated right ventricular noncompaction (IRVNC) is rare. Pulmonary artery sling (PAS) is a rare condition in which the left pulmonary artery anomalously originates from a normal positioned right pulmonary artery, and only a few studies have reported PAS in fetuses. Fetal IRVNC complicated with PAS has not been reported yet. Here, we report a case of ...

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Pregnancy outcomes of fetuses with congenital heart disease after a prenatal diagnosis with chromosome microarray

Zhang

Wang

et al. 2021

Prenatal Diagnosis

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Objective: To evaluate the pregnancy outcomes of fetuses with congenital heart disease (CHD) after chromosome microarray (CMA)-based prenatal diagnosis.Method: Amniocentesis was performed in 1035 pregnant women carrying fetuses with CHD between September 2014 and December 2019. Chromosomal aberrations in fetuses with CHD were evaluated using CMA. The pregnancy outcomes were followed up from 6 months to 5 years. Results:The overall CHD detection rate by CMA was 10.1% (105/1035; 50 fetuses: aneuploidy, 55 fetuses: pathogenic or likely pathogenic copy number variations).Among 1003 fetuses who were followed up, 4, 236, 763, and 18 cases were of miscarriages, pregnancy termination, live births, and postnatal deaths, respectively. Self-healed CHD was observed in 401 (52.6%) fetuses. The pregnancy termination rate of fetuses with chromosomal anomalies was significantly higher than that of fetuses without chromosomal anomalies (93.1% vs. 15.5%, p < 0.001). However, other pregnancy outcomes, including mortality, preterm labor, and low-weight birth rate, were similar between the two groups. Conclusion:The outcome of CMA is an important factor influencing parents' choice of whether to continue the pregnancy. Self-healing rate of prenatal diagnosed CHD is high. The mortality and morbidity of fetuses with CHD following prenatal CMA testing are relatively low. Key pointsWhat's already known about this topic?� Chromosomal microarray analysis (CMA) is a reliable and high-resolution technology and should be used as a first-tier test for the prenatal diagnosis of congenital heart disease (CHD) in clinical practice. What does this study add?� The mortality and morbidity of fetuses with CHD following prenatal CMA testing are relatively low.� Self-healing rate of prenatally diagnosed CHD, especially minor CHD, is high.

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

Cited by 8 publications

References 11 publications

Prenatal diagnosis of left pulmonary artery sling and review of literature

Prenatal diagnosis of left pulmonary artery sling and review of literature

Prenatal ultrasound diagnosis of fetal isolated right ventricular noncompaction with pulmonary artery sling: A rare case report

Pregnancy outcomes of fetuses with congenital heart disease after a prenatal diagnosis with chromosome microarray

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