Circulation. 1997;96:4432-4433
(Circulation. 1997;96:4432-4433.)
© 1997 American Heart Association, Inc.
Situs Inversus With Complete Transposition in the Fetus
Diagnostic Antenatal Sequential Segmental Analysis
Julene S. Carvalho, MD, PhD;
MRCPCH;
;
Phillipa M. Kyle, MD
From the Royal Brompton Hospital (J.S.C.) and Centre for Fetal Care,
Queen Charlotte's Hospital (J.S.C., P.M.K.), London, UK.
Correspondence to Dr J.S. Carvalho, Department of Paediatric Cardiology, Royal Brompton Hospital, Sydney St, London SW3 6NP, UK.
 |
Introduction
|
|---|
 Top
 Introduction
|
|---|
The
pictures presented here were obtained from a fetus at 20
weeks
of gestation. Detailed fetal echocardiography was
undertaken
because situs inversus had been diagnosed at an earlier
obstetric
ultrasound examination. Termination of pregnancy was carried
out
after antenatal diagnosis of complete transposition of the great
arteries
in the setting of situs inversus. Postmortem examination
confirmed
the antenatal
findings.
View larger version (142K):
[in this window]
[in a new window]
|
Figure 1. Determination of fetal visceral situs (breech
presentation). Maternal transverse sections show transverse
sections through fetus's abdominal (a) and thoracic regions (b). Note
that both stomach and heart are on right side of fetus, with apex of
heart pointing to right. SP indicates spine; ST, stomach; A, atrium;
and V, ventricle.
|
|
View larger version (111K):
[in this window]
[in a new window]
|
Figure 2. Determination of fetal atrial situs (breech
presentation). a, Transverse section through fetus's upper
abdomen demonstrates right-sided abdominal aorta and systemic venous
return to left side of fetus (a), leading to left-sided atrium (right
atrium) (b). SP indicates spine; Ao, aorta; SV, systemic vein; RA,
right atrium; and LA, left atrium.
|
|
View larger version (100K):
[in this window]
[in a new window]
|
Figure 3. Determination of atrioventricular
connection (breech presentation). Transverse section
through fetus's chest shows right-sided four-chamber view.
Visualization of offsetting of atrioventricular valves
(arrow) shows left-sided atrium (right atrium) to be connected to
ventricle of right ventricular morphology (anterior and
left-sided), and right-sided atrium (left atrium) connected to
morphologically left ventricle (posterior and right-sided). SP
indicates spine; RA, right atrium; LA, left atrium; RV, right
ventricle; and LV, left ventricle.
|
|
View larger version (85K):
[in this window]
[in a new window]
|
Figure 4. Determination of ventriculoarterial
connexion. Longitudinal views of fetus show anterior ventricle
(morphologically right) giving rise to anterior aorta (a).
Pulmonary artery, posterior to aorta, and duct (arrow) are also
identified (b, c). RV indicates right ventricle; LV, left ventricle;
Ao, aorta; and PA, pulmonary artery.
|
|
|
Footnotes
|
|---|
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister,
Jr, MD, Chief, Department of Pathology, St Luke's Episcopal
Hospital and Texas Heart Institute, and Clinical Professor of
Pathology, University of Texas Medical School and Baylor College
of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner, MC 1-267, Houston, TX 77030.
This article has been cited by other articles:
|
|
|
|
 
P. Jeanty, R. Chaoui, I. Tihonenko, and F. Grochal
A Review of Findings in Fetal Cardiac Section Drawings: Part 1: The 4-Chamber View
J. Ultrasound Med.,
November 1, 2007;
26(11):
1601 - 1610.
[Abstract]
[Full Text]
[PDF]
|
|
|
