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Main pulmonary artery cross-section ratio is low in fetuses with tetralogy of Fallot and ductus arteriosus-dependent pulmonary circulation

Published online by Cambridge University Press:  12 January 2017

Hironori Ebishima ,
Kenichi Kurosaki ,
Jun Yoshimatsu  and
Isao Shiraishi
Hironori Ebishima*
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Kenichi Kurosaki
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Jun Yoshimatsu
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Isao Shiraishi
Affiliation:
Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
*
Correspondence to: H. Ebishima, MD, Fujishirodai 5-7-1, Suita, Osaka 565-8565, Japan. Tel: +81 66833 5012; Fax: +81 66834 9535; E-mail: ebishimahironori@hotmail.com
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Abstract

Objectives

This study aimed to determine fetal echocardiographic features of tetralogy of Fallot in association with postnatal outcomes.

Methods

The Z-scores of the main and bilateral pulmonary arteries and the aorta were measured, and the following variables were calculated in 13 fetuses with tetralogy of Fallot: pulmonary artery-to-aorta ratio and main pulmonary artery cross-section ratio – the main pulmonary artery diameter squared divided by the sum of the diameter squared of the left and right pulmonary arteries. Fetuses were classified as having ductus arteriosus-dependent or ductus arteriosus-independent pulmonary circulation.

Results

We included two infants with pulmonary atresia and six infants with ductus-dependent pulmonary circulation, who underwent systemic-to-pulmonary shunt surgeries at ⩽1 month of age. The Z-scores of the main pulmonary artery and the pulmonary artery-to-aorta ratio in fetuses with ductus-dependent pulmonary circulation were lesser than those in fetuses with ductus independence, but not significantly. The main pulmonary artery cross-section ratio in fetuses with ductus dependence was significantly lesser (0.65±0.44 versus 1.56±0.48, p<0.005). Besides, the flow of the ductus arteriosus was directed from the aorta to the pulmonary artery in the ductus arteriosus-dependent group during the fetal period.

Conclusions

The main pulmonary artery cross-section ratio was the most significant variable for predicting postnatal outcomes in fetuses with tetralogy of Fallot.

Keywords

Tetralogy of Fallotfetal echocardiographycross-sectional areapulmonary artery diameterductus arteriosus dependent
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 6 , August 2017 , pp. 1162 - 1166
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Copyright
© Cambridge University Press 2017 

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