© 2009 by the American
Institute of Ultrasound in Medicine
J Ultrasound Med 2009;
28:9–12
0278-4297/09/$3.50
Aorta Larger Than Pulmonary Artery in the Fetal 3-Vessel View
Authors
Robert C Rollins, MD, Ruben J Acherman, MD, William J Castillo,
MD, William N Evans, MD,
Humberto Restrepo, MD, MPH
Source
ChildrenŐs Heart Center Nevada, 3006 S Maryland Pkwy, Ste 690,
Las Vegas, NV 89109, USA.
Email: rollins@childrensheartcenter.com.
Abstract
Objective. Fetal great artery asymmetry may accompany congenital heart
disease. The fetal echocardiographic 3-vessel view (3VV) allows assessment of
the superior vena cava, ascending aorta (AA), and main pulmonary artery (MPA).
Our aim was to determine the association of congenital heart disease in fetuses
with an AA/MPA ratio of greater than 1.
Methods. We electronically searched our fetal echocardiographic database
for studies performed between March 2002 and January 2008 that showed 3VVs with
AA/MPA ratios of greater than 1 and correlated the findings with the presence
of congenital heart disease.
Results. In 2797 fetal echocardiograms, we identified 31 fetuses with
normal 4-chamber views showing AA/MPA ratios of greater than 1 in the 3VV. Of
31 fetuses, 25 (81%)had tetralogy of Fallot (ToF) or
a ToF variant, and 6 (19%) had an aortic valve
abnormality or isolated dilatation of the AA.
Conclusions. Screening obstetric fetal sonography
showing a 3VV AA/MPA ratio of greater than 1 suggests congenital heart disease
and indicates the need for comprehensive fetal echocardiography.