3 – Poster Presentations

2019 Journal of Perinatal Medicine  
Objective Prenatal diagnosis of transposition of the great arteries (TGA) has been progressing, and the surgical outcome from the arterial switch operation is usually successful. However, some neonates, especially who have intact ventricular septum or small ventricular septal defect (VSD), show severe hypoxemia soon after birth and even die in preoperative period. In such cases, immediate balloon atrial septostomy (BAS) is needed in order to improve mixing of the pulmonary and systemic
more » ... on. We aimed to identify the prenatal echocardiographic features that may predict the need for urgent BAS. Methods We reviewed the echocardiograms of the fetuses prenatally diagnosed as TGA and managed at our institution between January 2012 and December 2018, retrospectively. We assessed their ductus arteriosus and foramen ovale on the basis of the past several studies. We measured the diameter of the ductus arteriosus and reviewed the Doppler flow pattern. Regarding the analysis of the atrial septum, we measured the maximal angle of flap of the foramen ovale and calculated the ratio of the maximal bulging of the foramen ovale towards the left atrial wall to the left atrial width, as well as the ratio of the foramen ovale length to the atrial septal length. We also focused on the shape of the foramen ovale. Results Among all 22 cases, 12 were included as TGA with intact ventricular septum or small VSD. 6 of them received the urgent BAS within 3 days after birth. The median gestational age at echocardiographic exam was 32 weeks in both fetuses who needed BAS and who didn't. The gestational age at birth and birth weight were not significantly different between the fetuses as well. There was no significant difference in the arterial duct z score, and no one had reverse ductal flow. The flap angle of the foramen ovale and ratio of length of foramen ovale to atrial septum were significantly small in patients who received urgent BAS in comparison with those who didn't. Hypermobility of the foramen ovale, which is defined as oscillation of its flap valve between the left and right atrium, was seen in 3 (50%) cases. Conclusion: The angle of flap of the FO, and FO to atrial septum length ratio which were obtained by fetal echo cardiogram can be helpful for predicting the need for urgent BAS after birth. eA328
doi:10.1515/jpm-2019-2502 pmid:33581005 fatcat:kd646w4thzcfpnxcenajzu4fmi