Evaluation of coronary artery fistula by fetal echocardiography

doi:10.3877/cma.j.issn.1672-6448.2018.11.007

Abstract

Abstract:

Objective

To investigate the value of prenatal echocardiography in the diagnosis of fetal coronary artery fistula (CAF).

Methods

From January 2016 to December 2017, a total of 9 fetuses were diagnosed as CAF in Wuhan Union Hospital by prenatal echocardiography. The two-dimensional gray-scale, color Doppler sonographic features, blood flow spectrum forms and associated anomalies of fetal CAF were evaluated retrospectively. In 5/9 cases the prenatal findings were compared with their postnatal echocardiography and autopsy results.

Results

Coronary artery dilation were found in all 9 fetuses. The origin, course, size, blood flow and drainage site of the fistula were showed by CDFI. The characteristic blood flow spectrum of fistula could be detected by spectrum Doppler. In the 9 fetuses, 2 cases were confirmed by postnatal transthoracic echocardiography, 3 cases were confirmed by autopsy after induced labor, while 4 cases were aborted without autopsy.

Conclusion

Fetal coronary artery fistula has echocardiographic characteristics. Prenatal diagnosis of coronary artery fistula is of great significance in evaluating fetal prognosis and early treatment.

Key words: Coronary artery fistula, Fetal, Echocardiography, Prenatal diagnosis

Haiyan Cao, Liu Hong, Yali Yang, Jing Wang, Jing Zhang, Yuan Peng, Mingxing Xie. Evaluation of coronary artery fistula by fetal echocardiography[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(11): 826-829.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2018.11.007

https://chaosheng.cma-cmc.com.cn/EN/Y2018/V15/I11/826

Figures/Tables 2

References 7

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病例	初诊胎儿孕龄（周）	受累冠状动脉	瘘入部位	扩张冠状动脉内径（cm）	瘘管内径（cm）	瘘管内血流速度（m/s）	血流频谱特征	主动脉弓舒张期血流反向	房室大小
1	25^＋6	LCA	RV	0.32	0.30~0.50	2.4	以舒张期为主的双期双向血流频谱	有	全心增大，右心室明显
2	25	LCA	RA	0.20	0.23~0.34	2.8	全心动周期连续性血流频谱	有	右心房增大
3	32^＋4	RCA	RA	0.30	0.20~0.30	1.6	全心动周期连续性血流频谱	有	无明显改变
4	25^＋1	LCA	RV	0.20	0.18~0.20	0.6	双期双向血流频谱	无	右心室明显小（HRHS）
5	24^＋4	LCA	RV	0.25	0.19~0.32	2.2	以舒张期为主的双期双向血流频谱	有	右心室心尖局限性膨大
6	30^＋3	LCA	RV	0.20	0.17~0.20	0.5	以舒张期为主的双期双向血流频谱	有	无明显改变
7	27^＋3	RCA	LV	0.23	0.19~0.24	0.6	以舒张期为主的双期双向血流频谱	有	无明显改变
8	29^＋4	LCA	RA	0.25	0.17~0.20	1.8	全心动周期连续性血流频谱	有	无明显改变
9	31^＋5	LCA	RV	0.20	0.19~0.22	1.2	以舒张期为主的双期双向血流频谱	无	无明显改变

病例	初诊胎儿孕龄（周）	受累冠状动脉	瘘入部位	扩张冠状动脉内径（cm）	瘘管内径（cm）	瘘管内血流速度（m/s）	血流频谱特征	主动脉弓舒张期血流反向	房室大小
1	25^＋6	LCA	RV	0.32	0.30~0.50	2.4	以舒张期为主的双期双向血流频谱	有	全心增大，右心室明显
2	25	LCA	RA	0.20	0.23~0.34	2.8	全心动周期连续性血流频谱	有	右心房增大
3	32^＋4	RCA	RA	0.30	0.20~0.30	1.6	全心动周期连续性血流频谱	有	无明显改变
4	25^＋1	LCA	RV	0.20	0.18~0.20	0.6	双期双向血流频谱	无	右心室明显小（HRHS）
5	24^＋4	LCA	RV	0.25	0.19~0.32	2.2	以舒张期为主的双期双向血流频谱	有	右心室心尖局限性膨大
6	30^＋3	LCA	RV	0.20	0.17~0.20	0.5	以舒张期为主的双期双向血流频谱	有	无明显改变
7	27^＋3	RCA	LV	0.23	0.19~0.24	0.6	以舒张期为主的双期双向血流频谱	有	无明显改变
8	29^＋4	LCA	RA	0.25	0.17~0.20	1.8	全心动周期连续性血流频谱	有	无明显改变
9	31^＋5	LCA	RV	0.20	0.19~0.22	1.2	以舒张期为主的双期双向血流频谱	无	无明显改变

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