TY - JOUR
T1 - Echocardiographic study of the morphology and growth of the aortic arch in the human fetus
T2 - Observations related to the prenatal diagnosis of coarctation
AU - Hornberger, Lisa K.
AU - Weintraub, Robert G.
AU - Pesonen, Erkki
AU - Murillo-Olivas, Azucena
AU - Simpson, Iain A.
AU - Sahn, Christine
AU - Hagen-Ansert, Sandra
AU - Sahn, David J.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1992/9
Y1 - 1992/9
N2 - Background. In a study of normal and abnormal growth of the aorta before birth, high-resolution echocardiographic imaging of the aortic arch in 92 normal fetuses aged 16-38 weeks was used to establish normal values for aortic arch dimensions at varying gestational ages. Methods and Results. From long-axis views of the aortic arch, the internal diameter of the aortic root, ascending aorta, transverse aortic arch, aortic isthmus, proximal descending thoracic aorta, and left common carotid artery were measured. Correlation coefficients for the diameter of each aortic arch segment when related to gestational age varied from r=0.87 to r=0.94 (p<0.001 for each), and growth curves were derived from the third and 97th percentiles around each linear regression analysis. In most of the fetuses, there was progressive tapering of the aortic arch, with the smallest diameter being at the isthmus. The ratio of the transverse aorta, isthmus, descending aorta, and aortic root to the ascending aorta remained relatively constant with gestational age, with mean values of 0.94, 0.81, 0.96, and 1.13, respectively. In five fetuses in whom a prenatal diagnosis of aortic coarctation was confirmed postnatally, transverse aortic and isthmic measurements fell on or below the third percentile for gestational age from the above data. In each case, the ratio of left common carotid artery to transverse aorta was ≥0.73 compared with ≤0.62 for the 92 normal fetuses (mean ratios, 0.77±0.05 [SD] for coarctation versus 0.48±0.08 for normal fetuses; p≤0.001). Conclusions. Use of normal growth curves for the developing aortic arch should facilitate the prenatal diagnosis of left heart and aortic arch abnormalities, particularly aortic coarctation, which until recently has been a difficult prenatal diagnosis to make with certainty.
AB - Background. In a study of normal and abnormal growth of the aorta before birth, high-resolution echocardiographic imaging of the aortic arch in 92 normal fetuses aged 16-38 weeks was used to establish normal values for aortic arch dimensions at varying gestational ages. Methods and Results. From long-axis views of the aortic arch, the internal diameter of the aortic root, ascending aorta, transverse aortic arch, aortic isthmus, proximal descending thoracic aorta, and left common carotid artery were measured. Correlation coefficients for the diameter of each aortic arch segment when related to gestational age varied from r=0.87 to r=0.94 (p<0.001 for each), and growth curves were derived from the third and 97th percentiles around each linear regression analysis. In most of the fetuses, there was progressive tapering of the aortic arch, with the smallest diameter being at the isthmus. The ratio of the transverse aorta, isthmus, descending aorta, and aortic root to the ascending aorta remained relatively constant with gestational age, with mean values of 0.94, 0.81, 0.96, and 1.13, respectively. In five fetuses in whom a prenatal diagnosis of aortic coarctation was confirmed postnatally, transverse aortic and isthmic measurements fell on or below the third percentile for gestational age from the above data. In each case, the ratio of left common carotid artery to transverse aorta was ≥0.73 compared with ≤0.62 for the 92 normal fetuses (mean ratios, 0.77±0.05 [SD] for coarctation versus 0.48±0.08 for normal fetuses; p≤0.001). Conclusions. Use of normal growth curves for the developing aortic arch should facilitate the prenatal diagnosis of left heart and aortic arch abnormalities, particularly aortic coarctation, which until recently has been a difficult prenatal diagnosis to make with certainty.
KW - Aortic arch
KW - Coarctation
KW - Echocardiography
KW - Fetus
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U2 - 10.1161/01.CIR.86.3.741
DO - 10.1161/01.CIR.86.3.741
M3 - Article
C2 - 1516185
AN - SCOPUS:0026792982
SN - 0009-7322
VL - 86
SP - 741
EP - 747
JO - Circulation
JF - Circulation
IS - 3
ER -