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Prenatal ultrasonic diagnosis and differential diagnosis of isolated right aortic arch with mirror-image branching

  • Images in Obstetrics and Gynecology
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Abstract

Purpose

This study sought to evaluate the fetal echocardiography features of isolated right aortic arch (RAA) with mirror-image branching and to improve the rate and accuracy of prenatal diagnosis of this condition.

Methods

We reviewed fetal echocardiograms from all cases of isolated RAA with mirror-image branching diagnosed at our institution between August 2012 and December 2015 and classified these cases into normal and abnormal types of ductus arteriosus based on the course of the arterial duct arch. We confirmed the diagnoses by postnatal echocardiography.

Results

A total of 11 cases of isolated RAA with mirror-image branching, with the left ductus and the descending aorta located on the left side of the spine, were diagnosed using fetal echocardiography. Ten cases involved normal ductus arteriosus, with the left ductus connecting the left pulmonary artery to the descending aorta, five of which were referred to our institution for suspicions of double aortic aorta. 1 case involved abnormal ductus arteriosus, with the left ductus connecting the left pulmonary artery to the left innominate artery.

Conclusions

RAA with mirror-image branching can be detected via fetal echocardiography, which can reveal the relationship between of the aortic arch and the trachea and can enable the identification of the course of brachiocephalic branching. The identification of isolated RAA with mirror-image branching is crucial for distinguishing this condition from other types of aortic arch anomalies, particularly double aortic aorta, which can have a rather different prognosis.

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Authors and Affiliations

  1. Department of Ultrasonography, Peking University People’s Hospital, Beijing, China

    Junxue Gao, Jiaan Zhu & Jianguo Li

  2. Department of Obstetrics and Gynecology, Peking University People’s Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China

    Qiuyan Pei

Authors
  1. Junxue Gao
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  2. Jiaan Zhu
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  3. Qiuyan Pei
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  4. Jianguo Li
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Corresponding author

Correspondence to Qiuyan Pei.

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Funding

This study was funded by The Capital Project of Fund Development (2011-4022-07).

Conflict of interest

All authors declares that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of Peking University People’s Hospital and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Gao, J., Zhu, J., Pei, Q. et al. Prenatal ultrasonic diagnosis and differential diagnosis of isolated right aortic arch with mirror-image branching. Arch Gynecol Obstet 295, 1291–1295 (2017). https://doi.org/10.1007/s00404-017-4310-3

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  • DOI: https://doi.org/10.1007/s00404-017-4310-3

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