Persistent left superior vena cava causing change in cardiac chamber size: anatomical and hemodynamic changes

Area of Science:

• Fetal cardiology
• Medical imaging
• Prenatal diagnostics

Background:

• Persistent left superior vena cava (PLSVC) is a common fetal anomaly.
• Understanding its impact on fetal anatomy is crucial for prenatal care.

Purpose of the Study:

• To evaluate the utility of 2D ultrasonography in assessing fetal cardiac and major artery dimensions.
• To compare measurements between fetuses with isolated PLSVC and normal fetuses.

Main Methods:

• Retrospective analysis of 166 isolated PLSVC cases and 166 controls.
• Measurement of fetal cardiac chamber and major artery diameters using 2D ultrasound.
• Analysis of diameters including ventriculus dexter (VD), atrium dextrum (AD), and aortic diameter (AOD).

Main Results:

• Significant differences in VD, AD, AOD, and pulmonary artery diameter (PAD) were observed in isolated PLSVC fetuses.
• Ratios of cardiac chambers (VD/VS, AD/AS) and arteries (PAD/AOD) also differed significantly.
• AD and AOD showed moderate diagnostic accuracy for PLSVC, with combined use improving predictive values.

Conclusions:

• Fetal isolated PLSVC is associated with measurable changes in cardiac chamber size.
• These hemodynamic changes, potentially due to coronary sinus dilation, are important for prenatal diagnosis.