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Aorta larger than pulmonary artery in the fetal 3-vessel view

Robert C Rollins1, Ruben J Acherman, William J Castillo

  • 1Children's Heart Center, Las Vegas, NV 89109, USA. rollins@childrensheartcenter.com

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
|December 25, 2008
PubMed

Insights

A fetal echocardiogram finding of an ascending aorta/main pulmonary artery ratio greater than 1 in the 3-vessel view (3VV) is associated with congenital heart disease, particularly tetralogy of Fallot.

Area of Science:

  • Fetal cardiology
  • Diagnostic imaging
  • Congenital abnormalities

Background:

  • Fetal great artery asymmetry can indicate congenital heart disease.
  • The 3-vessel view (3VV) in fetal echocardiography assesses the superior vena cava, ascending aorta (AA), and main pulmonary artery (MPA).

Purpose of the Study:

  • To investigate the association between an elevated AA/MPA ratio (>1) in the 3VV and the presence of congenital heart disease in fetuses.

Main Methods:

  • Retrospective analysis of fetal echocardiographic database from March 2002 to January 2008.
  • Identification of fetuses with a 3VV AA/MPA ratio >1 and correlation with congenital heart disease diagnosis.

Main Results:

  • 31 fetuses with normal 4-chamber views exhibited an AA/MPA ratio >1 in the 3VV.
  • 81% of these fetuses (25/31) had tetralogy of Fallot (ToF) or a ToF variant.
  • 19% (6/31) had aortic valve abnormalities or isolated AA dilatation.

Conclusions:

  • An increased 3VV AA/MPA ratio (>1) in fetal screening sonography is a potential indicator of congenital heart disease.
  • This finding necessitates further comprehensive fetal echocardiography for accurate diagnosis.
Abstract

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