Hostname: page-component-848d4c4894-ndmmz Total loading time: 0 Render date: 2024-05-04T13:38:38.462Z Has data issue: false hasContentIssue false
  • English
  • Français

Sequential segmental approach to fetal congenital heart disease

Published online by Cambridge University Press:  19 August 2008

Shi-Joon Yoo ,
Young Ho Lee ,
Kyoung Sik Cho  and
Dae-Young Kim
Shi-Joon Yoo*
Affiliation:
Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Young Ho Lee
Affiliation:
Department of Ultrasound, Samsung Cheil Hospital and Women's Healthcare Center, Sungkyunkwan University, Chung-ku, Korea
Kyoung Sik Cho
Affiliation:
Department of Diagnostic Radiology, Asan lAedical Center, Ulsan University, Songpa-ku, Seoul, Korea
Dae-Young Kim
Affiliation:
Department of Diagnostic Radiology, Chungbuk National University Hospital, Cheongju, Chungbuk, Korea
*
Shi-Joon Yoo, MD, FRCPC, Department of Diagnostic Imaging Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario, M5G 1X8Canada. Tel: (416) 813–6037, 6029; Fax: (416)813–7591. E-mail: shi-joon.yoo@sickkids.on.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

The sequential segmental approach is now universally used in the diagnosis of congenital heart disease. Its utilization during fetal sonography has not been well described. In this review, we show how the fetal heart can be approached in a sequential segmental manner by using six basic sonographic views. The transverse view of the fetal upper abdomen is obtained to determine the arrangement of the abdominal organs, which, in most cases, provides the important clues to the determination of the atrial arrangement. The four-chamber view is obtained to evaluate the atrioventricular junctions. The views of the left and right ventricular outflow tracts are obtained to evaluate the ventriculoarterial junctions. The three-vessel view and the aortic arch view are obtained for the evaluation of the arrangement and size of the great arteries, which provides the additional clues to the diagnosis of the abnormalities involving the ventriculoarterial junctions and the great arteries. The standard protocol to acquire these six basic views is also introduced.

Keywords

Congenital heart diseasesequential segmental analysisfetal sonographyfetal echocardiography
Type
Continuing Medical Education
Information
Cardiology in the Young , Volume 9 , Issue 4 , July 1999 , pp. 430 - 444
Copyright
Copyright © Cambridge University Press 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Anderson, RH, Ho, SYSequential segmental analysis — description and categorization for the millennium. Cardiol Young 1997; 7: 98–116.CrossRefGoogle Scholar
2.Freedom, RM, Mawson, JB, Yoo, S-J, Benson, LN. The segmental and sequential approach to congenital heart disease. In: Congenital Heart Disease: Textbook of Angiocardiography. Armonk NY: Futura, 1997: 95–120.Google Scholar
3.Copel, J, Pilu, G, Green, J, Hobbins, JC, Kleinman, CS. Fetal echocardiographic screening for congenital heart disease: the importance of the four-chamber view. Am J Obstet Gynecol 1987; 157: 648–655.CrossRefGoogle ScholarPubMed
4.McGahan, JPSonography of the fetal heart: findings on the hour-chamber view. AJR; 156: 547–553.CrossRefGoogle Scholar
5.Bromley, B, Estroff, JA, Sanders, SP, Parad, R, Roberts, D, Frigoletto, FD, Benacerraf, BR. Fetal echocardiography: accuracy and limitations in a population at high and low risk for heart defects. Am J Obstet Gynecol 1992; 166: 1473–1481.CrossRefGoogle Scholar
6.Sharland, GK, Allan, LD. Screening for congenital heart disease prenatally. Results of a 2 and 1/2-year study in the south east Thames region. Br J Obstet Gynaecol 1992; 99: 220–225.CrossRefGoogle ScholarPubMed
7.Benacerraf, BR. Sonographic detection of fetal anomalies of the aortic and pulmonary arteries: value of four-chamber view vs direct images. Am J Roentgenol 1994; 163: 1483–1489.CrossRefGoogle ScholarPubMed
8.Yoo, S-J, Lee, Y-H. Screening fetal echocardiography made easy. J Korean Soc Med Ultrasound 1997; 16: 299–306.Google Scholar
9.Yoo, S-J, Lee, Y-H, Kim, ES, Ryu, HM, Kim, MY, Choi, HK, Cho, KS, Kim, A. Three-vessel view of the fetal upper mediastinum: an easy means of detecting abnormalities of the ventricular outflow tracts and great arteries during obstetric screening. Ultrasound Obstet Gynecol 1997; 9: 173–182.CrossRefGoogle ScholarPubMed
10.Yoo, S-J, Lee, Y-H, Cho, KS. Abnormal three-vessel view on sonography: a clue to the diagnosis of congenital heart disease in the fetus. Am J Roentgenol 1999; 172: 825–830.CrossRefGoogle Scholar
11.Colloridi, V, Pizzuto, F, Ventriglia, F, Giancotti, A, Pachi, A, Gallo, P. Prenatal echocardiographic diagnosis of right atrial isomerism. Prenat Diagn 1994; 14: 299–302.CrossRefGoogle ScholarPubMed
12.Phoon, CK, Villegas, MD, Ursell, PC, Silverman, NH. Left atrial isomerism detected in fetal life. Am J Cardiol 1996; 77: 1083–1088.CrossRefGoogle ScholarPubMed
13.Sheley, RC, Nyberg, DA, Kapur, R. Azygous continuation of the interrupted inferior vena cava: a clue to prenatal diagnosis of the cardiothoracic syndromes. J Ultrasound Med 1995; 14: 381–387.CrossRefGoogle Scholar
14.Uemura, H, Ho, SY, Devine, WA, Anderson, RH. Atrial appendages and venoatrial connections in hearts with visceral heterotaxy. Ann Thorac Surg 1995; 60: 561–569.CrossRefGoogle ScholarPubMed
15.De Vore, GR, Siassi, B, Platt, LD. Fetal echocardiography: the prenatal diagnosis of tricuspid atresia (type 1c) during the second trimester of pregnancy. J Clin Ultrasound 1987; 15: 317–324.CrossRefGoogle Scholar
16.Allan, LD, Anderson, RH, Cook, AC. Atresia or absence of the left-sided atrioventricular connection in the fetus: echocardiographic diagnosis and outcome. Ultrasound Obstet Gynecol 1996; 8: 295–302.CrossRefGoogle ScholarPubMed
17.Allan, LD. Sonographic detection of parallel great arteries in the fetus. Am J Roentgenol 1997; 168: 1283–1286.CrossRefGoogle ScholarPubMed
18.Paladini, D, Rustico, M, Todros, T, Palmieri, S, Gaglioti, P, Benettoni, A, Russo, MG, Chippa, E, D'Ottavio, G. Conotruncal anomalies in prenatal life. Ultrasound Obstet Gynecol 1996; 8: 241–246.CrossRefGoogle ScholarPubMed