Obstetric

		Introduction
		Clinical Guides 294
		Case Studies 26
		Feedback

		Create Document

Search Obstetric:

Aorta - Coarctation

Summary   Ultrasound Features   Differential Diagnoses   Syndromes   Images 5   Show All

Tricuspid dysplasia can be difficult to distinguish from Ebstein's malformation, in fact the two overlap each other in terms of anatomical findings. The differentiation is not important. The displaced tricuspid valve cusps can be difficult to find in a severe case of Ebstein's malformation and may therefore be mistaken for an unguarded orifice. However, in this condition, there is gross tricuspid regurgitation with hepatic congestion. If the left ventricle is very small and compressed by the right atrium it may be mistaken for a hypoplastic left heart, although this diagnosis should be reserved for cases of mitral atresia. The dilated right atrium has been mistaken for an intrathoracic cyst but blood flow within the atrial chamber should distinguish the two. In fetal life, the first clue to the diagnosis is asymmetry of the four chamber view, with the right ventricle dilated relative to the left. The left atrium, left ventricle and ascending aorta are slightly small for the gestational age. The pulmonary artery/aortic ratio is increased above normal and this and the hypoplasia of the transverse arch are more reliable predictors of this malformation than the relative ventricular sizes. The interatrial shunt is often reversed to become left to right. The transverse arch is narrowed in the horizontal views, especially in comparison with the arterial duct which will appear 'fat'. It is unusual to see a discrete shelf in the posterior arch, which typifies this lesion in postnatal life. Associated cardiac lesions which are common include VSD and aortic stenosis. As the pregnancy advances, the left heart can become progressively hypoplastic, such that this can develop into a form of hypoplastic left heart syndrome. References Title: In: Paediatric Cardiology Author: Anderson RH, McCartney FJ, Shinebourne EA, Tynan M (Eds) Journal: Churchill Livingstone: Edinburgh, p1087-1123 Year: 1987 Title: Prospective diagnosis of 1,006 consecutive cases of congenital heart disease in the fetus Author: Allan LD, Sharland GK, Milburn A, Lockhart SM, Groves AMM, Anderson RH, Cook AC, Fagg NLK Journal: J Am Coll Cardiol 23:1452-8 Year: 1994 Title: Aortic interruption and coarctation In: Color Atlas of Fetal Cardiology Author: Allan LD, Sharland G, Cook A Journal: Mosby-Wolfe: London, p123-127 Year: 1994 Title: In: Heart Disease in Infants, Children and Adolescents Author: Gersony WM Journal: Adams FH, Emmanouilides GC, Riemenschneider TA (Eds) Williams and Wilkins: Baltimore, p243-255 Year: 1989 Title: Coarctation of the aorta in prenatal life: an echocardiographic, anatomical and functional study Author: Allan LD, Chita SK, Anderson RH, Fagg N, Crawford DC, Tynan MJ Journal: Br Heart J 59:356-360 Year: 1988 Title: Coarctation of the aorta: difficulties in prenatal diagnosis Author: Sharland GK, Chan K, Allan LD Journal: Br Heart J 71:70-75 Year: 1994 Title: Antenatal diagnosis of coarctation of the aorta: a multicenter experience Author: Hornberger LK, Sahn DJ, Kleinman CS, Copel J, Silverman NH Journal: J Am Coll Cardiol 23:417-23 Year: 1994 Title: Echocardiographic study of the morphology and growth of the aortic arch in the human fetus: observations related to the prenatal diagnosis of coarctation Author: Hornberger LK, Weintraub RG, Pesonen E, Murillo-Olivas A, Simpson IA, Sahn C, Hagen-Ansert S, Sahn DJ Journal: Circulation 86:741-7 Year: 1992 Title: fetalis, and female genitalia Author: Lacro RV, Jones KL, Benirschke K Journal: Pediatrics 81:445-51 Year: 1988 Title: Sonographic diagnosis of fetal coarctation of the aorta at 14-16 weeks of gestation. Author: Bronshtein M; Zimmer EZ Journal: Ultrasound Obstet Gynecol Apr;11(4):254-7 Year: 1998 Title: [Disproportion in diameter of the cardiac chambers and great arteries in the fetus. Contribution to the prenatal diagnosis of coarctation of the aorta] Author: David N; Iselin M; Blaysat G; Durand I; Petit A Journal: Arch Mal Coeur Vaiss May;90(5):673-8 Year: 1997 Title: Ventricular discrepancy as a sonographic sign of coarctation of the fetal aorta: how reliable is it? Author: Brown DL; Durfee SM; Hornberger LK Journal: J Ultrasound Med Feb;16(2):95-9 Year: 1997 Title: Nuchal translucency: a marker for the antenatal diagnosis of aortic coarctation. Author: Moselhi M; Thilaganathan B Journal: Br J Obstet Gynaecol Oct;103(10):1044-5 Year: 1996

© 2004 Australasian Society for Ultrasound in Medicine