The prenatal diagnosis ,classification and outcome of anomalous origin of pulmonary artery from ascending aorta
10.3760/cma.j.issn.1004-4477.2019.01.007
- VernacularTitle:肺动脉异常起源于升主动脉的产前诊断 、分型与结局
- Author:
Zheng WANG
1
;
Jun LI
;
Ting ZHU
;
Peng XU
;
Yun WANG
;
Wenjuan YANG
;
Yin WANG
;
Weilun GAO
;
Jianfang ZHANG
;
Shen PANG
;
Xiaoli ZHU
Author Information
1. 空军军医大学第一附属医院超声医学科 陕西省先天性心脏病超声诊断中心
- Keywords:
Ultrasonography;
prenatal;
Fetus;
Abnormal origin of pulmonary artery from ascending aorta
- From:
Chinese Journal of Ultrasonography
2019;28(1):31-35
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical value of fetal echocardiography in prenatal diagnosis , classification and outcome of abnormal origin of pulmonary artery from ascending aorta ( AOPA) . Methods From January 2014 to June 2018 ,18 cases of AOPA diagnosed by echocardiography in 43966 fetuses from Shaanxi Fetal Congenital Heart Disease Diagnostic Center were retrospectively analyzed . The echocardiographic features ,pathological and anatomical classification ,genetic characteristics and outcome of postnatal echocardiography were summarized . Results Abnormal origin of pulmonary artery branches could be demonstrated by color Doppler imaging system in 18 cases . Ten cases ( 55 .6％ ) of right pulmonary artery abnormalities originated from ascending aorta ( AORPA ) ,in which 6 cases ( 60％ ) were distal pulmonary artery abnormalities ,4 cases ( 40％ ) were proximal pulmonary artery abnormalities . Eight cases( 44 .4％ ) of left pulmonary artery abnormalities originated from ascending aorta ( AOLPA ) ,including 7 cases ( 87 .5％ ) of distal pulmonary artery abnormalities and 1 case ( 12 .5％ ) of proximal pulmonary artery abnormalities . Twelve AOPAs were associated with other intracardiac malformations with 6 right ventricular double outlet (DORV) accompanying with pulmonary stenosis ,3 tetralogy of fallots( TOF) ,2 atrioventricular septal defects( AVSD) ,1 single ventricle with single atrium ,and 1 Berry syndrome ,and no casese were associated with extracardiac malformations .Amniocentesis karyotype analysis and gene chip detection in 5 cases showed normal results . Four of 18 cases were born ,in which 3 cases died and 1 case was progressively suffered with right pulmonary artery atresia ,10 cases were inducted of labor ( 4 autopsy) and following-up was lost in 4 cases . Conclusions Incidence of AOLPA and distal type in fetal AOPA is higher than that in child and adult from references ,DORV is abnormal type mostly associated with intracardiac malformation . AOPA has no obvious genetic result for less cases . The main risk after AOPA birth is pulmonary infection . Echocardiography is of great value for AOPA in prenatal diagnosis , outcome observation and surgical planning after birth .
