Table 2 Abnormal structures that are important for cardiac screening sonographers
From: Identification of fetal cardiac anatomy and hemodynamics: a novel enhanced screening protocol
Abnormal signs | Possible anomalies |
|---|---|
Up-abdominal and 4CV level | |
Associated with cardiac malposition | |
The heart and the gastric vacuole are both on the right side | Mirror-image heart or complete situs inversus |
The heart is on the right side while the gastric vacuole on the left side | Dextrocardia; suggesting a high incidence of CHD |
The heart is on the left side while the gastric vacuole on the right side | Heterotaxy; suggesting a high incidence of CHD |
4CV shows the displacement of the heart to the right side | Cardiomediastinal shift caused by extra-cardiac situations |
Associated with systemic/pulmonary veins connection | |
A vein flowing cranially was visualized adjacent to the DAO at the 4CV | It may be the azygos or hemizygous continuation of IVC interruption. It is necessary to determine whether IVC is connected with RA |
A vein flowing caudally was visualized next to the DAO at the 4CV | It may be TAPVC with an infradiaphragmatic connection. It is necessary to confirm whether PVs is connected with LA. |
Vein-like structure was visualized between DAO and LA at the 4CV | It may be pulmonary veins pool. It is necessary to confirm PVs is connected with LA |
Coronary sinus was visualized at the atrioventricular groove at the 4CV | It may be caused by the drainage of aberrant PVs or LSVC |
3VT level | |
A supernumerary Vein-like structure was visualized at the left side of the PA at the 3VT | It may be LSVC |
A U-shaped confluence of ductal and aortic arches with the trachea and esophagus located between the two arches | Right-sided aortic arch; suggesting “rings and slings” |