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Fetal Echocardiographic Measures to Improve the Prenatal Diagnosis of Coarctation of the Aorta

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Abstract

The objective of this study is to identify fetal echocardiographic measures that predict postnatal coarctation of the aorta (CoA). A retrospective review of patients from 2013 to 2017 identified 13 cases of prenatal diagnosis of CoA confirmed postnatally and 14 cases of prenatal diagnosis of CoA with normal arches postnatally. There were 30 controls. Measurements were made and indices applied on all available longitudinal fetal echocardiograms for each patient. Linear mixed effects models were used to examine the between-group differences in the trajectories of the measurements. Significant differences were seen in the true CoA group for the following: smaller distal transverse arch diameter to distance between the left common carotid and left subclavian arteries (DT/LCA–LSCA) index (p = 0.04), smaller distal transverse arch diameter (p = 0.005), and longer brachiocephalic to left common carotid artery (LCA) (p = 0.004) and LCA–left subclavian artery (LSCA) distances (p < 0.0001). Additionally, the LCA/DT index trend appears to differentiate false positives from true coarctations (p < 0.03). The fetal echocardiographic DT/LCA–LSCA index, brachiocephalic–LCA distance and LCA–LSCA distance are significant predictors of postnatal coarctation. The LCA/DT index trend over time may differentiate which of those patients with prenatal concern for coarctation are more likely to develop coarctation postnatally. The use of fetal echocardiographic measures may improve prenatal detection and predication of postnatal coarctation.

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Acknowledgements

This publication was made possible by CTSA Grant Number UL1 RR024139 from the National Center for Research Resources (NCRR) and the National Center for Advancing Translational Science (NCATS), components of the National Institutes of Health (NIH), and NIH roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH.

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Authors and Affiliations

  1. Department of Pediatrics, Pediatric Cardiology, Yale School of Medicine, 333 Cedar St, LLCI 302, New Haven, CT, 06510, USA

    Chandni Patel, John Fahey & Dina J. Ferdman

  2. Congenital Heart Center, University of FL Health, Gainesville, FL, USA

    Bevin Weeks

  3. Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Yale School of Medicine, New Haven, CT, USA

    Joshua Copel

  4. Yale School of Public Health, New Haven, CT, USA

    Xuemei Song

  5. Department of Pediatrics, Yale University, New Haven, CT, USA

    Veronika Shabanova

Authors
  1. Chandni Patel
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  2. Bevin Weeks
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  3. Joshua Copel
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  4. John Fahey
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  5. Xuemei Song
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  6. Veronika Shabanova
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  7. Dina J. Ferdman
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Correspondence to Chandni Patel.

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All authors declare no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

This study was a retrospective review of imaging studies previously completed. Informed consent was not necessary as deemed by our institutional review board.

Appendix

Appendix

See Table 3.

Table 3 Number of individual measurements collected by group type
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Patel, C., Weeks, B., Copel, J. et al. Fetal Echocardiographic Measures to Improve the Prenatal Diagnosis of Coarctation of the Aorta. Pediatr Cardiol (2018). https://doi.org/10.1007/s00246-018-2040-3

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  • DOI: https://doi.org/10.1007/s00246-018-2040-3

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