Image characteristics and main types of abnormal branching of fetal pulmonary artery in prenatal echocardiography — a retrospective study
Abstract
Objectives: To explore the image characteristics and main types of abnormal branching of fetal pulmonary artery in prenatal echocardiography.
Material and methods: A retrospective analysis of 41 cases diagnosed with abnormal branching of fetal pulmonary artery by prenatal echocardiography was made. The image characteristics of the abnormalities, their combination with intra- or extra-cardiac malformations and chromosomal anomalies were analyzed.
Results: The results of prenatal echocardiography showed that, among the 41 cases, 1) 4 cases were with anomalous origin of single pulmonary artery, 8 cases with pulmonary artery agenesis, 9 cases with pulmonary artery sling; 20 cases with crossed pulmonary arteries. 2) 11 cases were complicated with intracardiac malformations and 10 with extracardiac malformations. 3) Only 7 case underwent chromosomal examination and 1 tested abnormal. 4) Pregnancy outcomes: 25 fetuses were born and their abnormalities confirmed by echocardiography (MRI or surgery) to be consistent with prenatal ultrasound diagnosis; 16 cases had their pregnancy terminated due to their combination with other severe malformations, which were confirmed by pathological anatomy after induced abortion.
Conclusions: Prenatal echocardiography can provide detailed images for the diagnosis of abnormal branching of fetal pulmonary artery, which can be complicated by intra- and extracardiac malformations and chromosomal anomalies and should be alerted.
Keywords: prenatal diagnosisechocardiographyabnormal branching of pulmonary artery
References
- Hirsig LE, Sharma PG, Verma N, et al. Congenital Pulmonary Artery Anomalies: A Review and Approach to Classification. J Clin Imaging Sci. 2018; 8: 29.
- Han J, Yu S, Hao X, et al. Prenatal Diagnosis of Bilateral Ductus Arteriosi and an Anomalous Origin of the Right Pulmonary Artery From the Right-Sided Duct. J Ultrasound Med. 2018; 37(12): 2961–2962.
- Chen L, Xu H, Zhou L, et al. Prenatal diagnosis of ductal origin of distal pulmonary artery: presentation of three cases and literature review. Ultrasound Obstet Gynecol. 2022; 60(2): 284–290.
- Karmegaraj B, Vaidyanathan B. Right aortic arch, bilateral ductus arteriosus, and anomalous origin of left pulmonary artery from innominate artery in a fetus with normal intracardiac anatomy. Echocardiography. 2020; 37(5): 796–798.
- Li X, Mu Z, Li Xu, et al. Prenatal diagnosis of anomalous origin of pulmonary artery. Prenat Diagn. 2018; 38(5): 310–317.
- Binsalamah ZM, Greenleaf CE, Heinle JS. Type A interrupted aortic arch and type III aortopulmonary window with anomalous origin of the right pulmonary artery from the aorta. J Card Surg. 2018; 33(6): 344–347.
- Dönmez YN, Aykan HH, Peker RO, et al. Association of interrupted aortic arch, aortopulmonary window with anomalous origin of the right pulmonary artery from the aorta, one-stage repair and postoperative outcomes: A case report. Anatol J Cardiol. 2021; 25(6): 447–450.
- Musab Hamoud A, Mshari Fahad A, Atheer Abdullah A, et al. Late diagnosis of anomalous right pulmonary artery originated from ascending aorta: Associated with small pulmonary artery aneurysm. Radiol Case Rep. 2020; 15(11): 2294–2302.
- Garg P, Talwar S, Kothari SS, et al. The anomalous origin of the branch pulmonary artery from the ascending aorta. Interact Cardiovasc Thorac Surg. 2012; 15(1): 86–92.
- Seedat F, Kalla IS, Feldman C. Unilateral absent pulmonary artery in an adult - A diagnostic and therapeutic challenge. Respir Med Case Rep. 2017; 22: 238–242.
- Wang Yu, Zhang J, Feng W, et al. Absence of the fetal right pulmonary artery complicated with coarctation of the aorta: Prenatal and postnatal diagnosis. Echocardiography. 2019; 36(9): 1787–1789.
- Wenxiu Li, Yuan Z, Chaoning H, et al. Prenatal diagnosis of anomalous origin of one pulmonary artery branch by two-dimensional echocardiography: summary of 12 cases. Cardiol Young. 2020; 30(1): 39–46.
- Pan JY, Lin CC, Chang JP. Fontan Operation in a Patient with Severe Hypoplastic Right Pulmonary Artery, Single Ventricle, and Heterotaxy Syndrome. Acta Cardiol Sin. 2016; 32(5): 612–615.
- Tian M, Zheng M. Unilateral absence of pulmonary artery analysis based on echocardiographic feature. Rev Cardiovasc Med. 2021; 22(2): 483–488.
- Garg A, Azad S, Radhakrishnan S. Isolated absent right pulmonary artery in an infant with 22q11 deletion. Cardiol Young. 2021; 31(11): 1850–1852.
- Wang G, Zhou G. Left superior pulmonary artery sling. J Card Surg. 2019; 34(12): 1659–1660.
- Muthialu N, Martens T, Kanakis M, et al. Repair of pulmonary artery sling with tracheal and intracardiac defects. Asian Cardiovasc Thorac Ann. 2020; 28(8): 463–469.
- Tedla B, Golding F, Ryan J, et al. Fetal Diagnosis of Dextroposition, Left Pulmonary Artery Sling, Partial Anomalous Left Pulmonary Artery, and Aortic Coarctation. CASE (Phila). 2022; 6(3): 114–118.
- Matsumoto Y, Kamada M, Nakagawa N, et al. Double vascular ring: a case report of double aortic arch and concurrent pulmonary artery sling. Eur Heart J Case Rep. 2019; 3(2).
- El Batti S, Ben Abdallah I, Julia P, et al. Crossed pulmonary arteries as additional cause of dysphagia in association with right aortic arch and Kommerell diverticulum. Surg Radiol Anat. 2018; 40(10): 1165–1168.
- Delogu AB, Mariani F, Graziani F, et al. Pulmonary artery sling in a 22-month-old boy with 18q deletion syndrome: A rare but possible association. Echocardiography. 2022; 39(5): 741–744.
- Xiong Y, Gan HJ, Liu T, et al. Prenatal diagnosis of crossed pulmonary arteries. Ultrasound Obstet Gynecol. 2010; 36(6): 776–777.
- Raza R, Khandwala K, Qayyum H, et al. A Variant of Crossed Pulmonary Arteries in Association with Coarctation of Aorta. Cureus. 2018; 10(4): e2477.