Prenatal diagnosis of atrial isomerism in the Korean population.
10.5468/ogs.2014.57.3.193
- Author:
Mi Young LEE
1
;
Hye Sung WON
;
Jae Yoon SHIM
;
Pil Ryang LEE
;
Byong Sop LEE
;
Ellen Ai Rhan KIM
;
Young Hwue KIM
;
Jeong Jun PARK
;
Tae Jin YUN
;
Ahm KIM
Author Information
1. Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. hswon@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Echocardiography;
Heart defects, congenital;
Heterotaxy syndrome;
Prenatal diagnosis
- MeSH:
Atrioventricular Block;
Bradycardia;
Double Outlet Right Ventricle;
Echocardiography;
Fetus;
Heart Block;
Heart Defects, Congenital;
Heart Septal Defects, Ventricular;
Heterotaxy Syndrome;
Humans;
Infant;
Isomerism*;
Live Birth;
Lost to Follow-Up;
Prenatal Diagnosis*;
Prevalence;
Pulmonary Atresia;
Retrospective Studies;
Survival Rate;
Vena Cava, Inferior;
Vena Cava, Superior
- From:Obstetrics & Gynecology Science
2014;57(3):193-200
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To report our experiences in the prenatal diagnosis of atrial isomerism and postnatal outcomes. METHODS: A total of 80 fetuses prenatally diagnosed with atrial isomerism were retrospectively analyzed between 1999 and 2011 at a single institution. RESULTS: Of 43 fetuses with prenatally diagnosed right atrial isomerism (RAI), 40 cases were analyzed. The diagnostic accuracy was 93%. The main intracardiac anomalies in RAI were atrioventricular septal defect (AVSD), abnormal pulmonary venous connection, bilateral superior vena cava (BSVC), and pulmonary atresia. Among 28 live births, three infants were lost to follow up, and the overall survival rate was 60%. Of 37 fetuses with prenatally diagnosed left atrial isomerism (LAI), 35 were evaluated. The diagnostic accuracy was 97%. The main intracardiac anomalies in LAI were ventricular septal defect, BSVC, AVSD, double outlet right ventricle, and bradyarrhythmia. Among seven patients with bradyarrhythmia, only one showed a complete atrioventricular block. All fetuses had an interrupted inferior vena cava with azygous continuation. The overall survival rate was 90%. CONCLUSION: Our study confirms the previous findings of fetal atrial isomerism. We also demonstrates a much lower prevalence of AVSD and complete heart block in LAI and a better survival rate in RAI. Although the postnatal outcomes for RAI were worse than those for LAI, successful postnatal surgery with active management improved the survival rate.
