2009-06-21-08 Transposition of great arteries © Cuillier www.thefetus.net/
Transposition of great arteries
Fabrice Cuillier, MD.
Department of Gynecology, Felix Guyon Hospital, 97400 Saint-Denis, Reunion Island, France.
A 26-year-old woman (G3P2) was referred to our antenatal unit at 37 weeks of gestation due to a fetal cardiopathy. There was no known family history of congenital disease and the patient didn’t take any teratogenic drugs. Our sonographic examination at 37 weeks revealed:
• Transposition of the great arteries;
• Ventricular septal defect.
The parents opted for the continuation of the pregnancy. An amniocentesis was done and revealed normal karyotype. The findings were confirmed after birth
Images 1, 2, 3, and video 1: 37 weeks; the image 1 shows a transverse scan of the fetal heart obtained at the level slightly above the four chamber view of the heart and depicting the pulmonary artery arising from the left ventricle. The image 2 was obtained at the level slightly more cranially than the level of the image 1 and shows the aorta arising from the right ventricle. Note that the pulmonary artery and aorta have the same parallel direction. The image 3 shows the two levels depicted at the images 1 and 2 - the level of the pulmonary artery has a blue tinge (Level I) and the level of the aorta has a red tinge (Level II). Note the parallel direction of both great vessels. (RV - right ventricle, LV - left ventricle, DA descending aorta). The video 1 shows the parallel direction of the pulmonary artery and aorta at the two levels depicted on the images 1, 2, and 3.
Images 4, 5, 6 and video 2: 37 weeks; the images and video show color Doppler scans of the outflow tracts of the heart. The aorta and pulmonary artery have the same parallel direction. (AP - pulmonary artery, Ao - aorta).
Images 7, 8: 37 weeks; the images show muscular ventricular defect of the heart (dimension 3 on the image 7 and the blue jet on the image 8).