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Fetal aortic isthmus

Shi Zeng, Jiawei Zhou, Qinghai Peng, Wen Deng, Ming Zhang, Yili Zhao, Tao Wang, Qichang Zhou
The aim was to investigate the impact of maternal hyperoxygenation (HO) on cardiac dimensions in fetuses with isolated Coarctation (CoA). Fetal echocardiography was performed serially in 48 fetuses with CoA and gestation age matched normal fetues. The Z-scores for the mitral valve (MV), tricuspid valve (TV), aortic valve (AV), ascending aorta (AAo), isthmus, pulmonary valve (PV), main pulmonary artery (MPA), and descending aorta (DAo) were measured and compared among normal fetuses, CoA fetuses with oxygen and CoA fetuses with air...
December 16, 2016: Scientific Reports
Jean-Claude Fouron, Ariane McNeal-Davidson, Sylvia Abadir, Anne Fournier, Jean-Luc Bigras, Christine Boutin, Myriam Brassard, Marie-Josée Raboisson, Nicolaas van Doesburg, Annie Berger, Sophie Brisebois, Roxanne Gendron
OBJECTIVES: Since postnatal identification of accelerated idioventricular rhythm (AIVR) is essentially based on specific electrocardiographic patterns, its prenatal diagnosis is challenging and its genuine incidence undetermined. Therefore the objectives of this study are: 1) To evaluate the performance of specific ultrasonographic approaches in intrauterine identification of cardiocirculatory events linked to electrocardiographic signs of AIVR, including its left or right ventricular origin, and 2) To assess the prenatal prognosis of the arrhythmia...
December 10, 2016: Ultrasound in Obstetrics & Gynecology
Xiaoyan Gu, Yihua He, Ye Zhang, Lin Sun, Ying Zhao, Jiancheng Han, Xiaowei Liu
OBJECTIVE: Global racial variability in human development can lead to differences in size of fetal cardiac structures during gestation. Our objective is to establish normal reference ranges of fetal cardiac dimensions between 20 and 34 weeks from fetal echocardiograms recorded at a single center in China. METHODS: A prospective cross-sectional study was undertaken on single pregnancies with normal fetuses of varying gestational ages (GAs). A total of 4396 normal fetuses were divided into 15 groups from 20 to 34 weeks according to the GA...
February 1, 2017: Journal of Perinatal Medicine
D Paladini, B Deloison, A Rossi, G E Chalouhi, C Gandolfo, P Sonigo, S Buratti, A E Millischer, G Tuo, Y Ville, A Pistorio, A Cama, L J Salomon
OBJECTIVE: Vein of Galen aneurysmal malformation (VGAM) is a rare anomaly in which an adequate perinatal management may warrant good neurological outcome. However, most fetal series are too scant to allow reliable statistical assessment of poor prognostic factors. Aim of this paper is to assess, in a two-center series of 49 cases, the prognostic value of several prenatal variables. The primary endpoint of the analysis is to identify possible prenatal indicators of poor outcome, in terms of mortality and cerebral disabilities...
August 12, 2016: Ultrasound in Obstetrics & Gynecology
Dominique Tynan, Jennifer Alphonse, Amanda Henry, Alec W Welsh
The aortic isthmus (AoI) is a unique fetal watershed with a waveform reflecting its complex haemodynamic physiology. The systolic component represents left and right ventricular systolic ejection, and the diastolic component represents comparative downstream vascular impedance between the brachiocephalic and subdiaphragmatic fetal circulations. Several indices have been devised to quantify different components of the waveform, including the pulsatility index, resistance index, isthmic flow index, and recently the isthmic systolic index...
2016: Fetal Diagnosis and Therapy
Xiaowei Liu, Yihua He, Zhiyun Tian, Jack Rychik
Ventricular size discrepancy may be due to a persistent left superior vena cava (PLSVC) in utero. We sought to investigate for differences in cardiac structure measures and hemodynamics between fetuses with isolated PLSVC connected to the coronary sinus (CS) and normal. Fetuses diagnosed with isolated PLSVC in the second and third trimester were enrolled. We defined two groups: group 1, twenty-five fetuses in the second trimester (22-27 W + 6d); group 2, twenty-two fetuses in the third trimester (28-39 W + 6d)...
August 2016: Pediatric Cardiology
Julie Blanc, Jean-Claude Fouron, Sven-Erik Sonesson, Marie-Josée Raboisson, Ian Huggon, Roxanne Gendron, Annie Berger, Sophie Brisebois
INTRODUCTION: Our objective was to determine the impact of simple transposition of the great arteries (TGA) on fetal left ventricular (LV) and right ventricular (RV) performances and central circulatory dynamics including the aortic isthmus. MATERIAL AND METHODS: Ventricular stroke volumes were calculated as the product of the cross-sectional area of the corresponding semi-lunar valve and the flow velocity integral through these valves. Volume flow in ductus arteriosus (QDA ) was evaluated using the same technique...
2016: Acta Obstetricia et Gynecologica Scandinavica
Patricia Garcia-Canadilla, Fatima Crispi, Monica Cruz-Lemini, Brenda Valenzuela-Alcaraz, Paula A Rudenick, Eduard Gratacos, Bart H Bijnens
OBJECTIVE: The aortic isthmus (AoI) blood flow has a characteristic shape with a small end-systolic notch observed during the third trimester of pregnancy. However, what causes the appearance of this notch is not fully understood. We used a lumped model of the fetal circulation to study the possible factors causing the end-systolic notch and the changes of AoI flow through gestation. METHODS: A validation of the model was performed by fitting patient-specific data from two normal fetuses...
2017: Fetal Diagnosis and Therapy
Amy-Lee Gunter, Zahra Keshavarz-Motamed, Rocco Portaro, Lyes Kadem, Hoi Dick Ng
The initial stages of fetal development require that blood oxygenation occur through the placenta rather than the non functioning lungs. As a result the fetal circulatory system develops a temporary shunt between the aorta and pulmonary artery, known as the ductus arteriosis (DA). This study utilizes CFD techniques to analyze the flow behavior in the aortic isthmus neighboring the DA. The geometry used to represent these structures is equivalent to that of a 25 week old fetus. The effect of aortic and pulmonary pressure pulse wave delay is examined for producing flow disturbances in the fetal circulatory system...
August 2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
R Arias-Ortega, J C Echeverría, M Guzmán-Huerta, L Camargo-Marín, M J Gaitán-González, H Borboa-Olivares, E Portilla-Islas, S Camal-Ugarte, C Vargas-García, M R Ortiz, R González-Camarena
BACKGROUND: The autonomic behavior of growth-restricted fetuses at different evolving hemodynamic stages has not been fully elicited. AIM: To analyze the respiratory sinus arrhythmia (RSA) of growth-restricted fetuses that despite this severe condition show normal Doppler hemodynamics. SUBJECTS: 10 growth-restricted fetuses (FGR group) with normal arterial pulsatility indices (umbilical, uterine, middle cerebral, ductus venosus and aortic isthmus), and 10 healthy fetuses (Control group), 32-37weeks of gestation...
February 2016: Early Human Development
Claudiu Mărginean, Cristina Oana Mărginean, Iolanda Muntean, Rodica Togănel, Septimiu Voidăzan, Liliana Gozar
AIM: To analyze the role of ventricular disproportion, aortic, and ductal isthmus ultrasound measurements for the diagnosis of fetal aortic coarctation (AoCo) and to evaluate the prediction of a needed neonatal surgical intervention in the presence of a diagnosis of AoCo. MATERIAL AND METHODS: We performed a prospective study on 41 fetuses (pregnancy age- 32 to 39 weeks, median 36 weeks) evaluated for left ventricle (LV) < right ventricle (RV) disproportion. Four fetuses were lost from evidence and five fetuses with complex cardiac malformations were excluded...
December 2015: Medical Ultrasonography
Joseph J Smolich, Kelly R Kenna, Jonathan P Mynard
Arterial reservoir ("windkessel") function, whereby a part of left ventricular (LV) output is stored in elastic arteries during systole and discharged in diastole, is a well-established physiological phenomenon. However, its role in rapid reversal (to left-to-right) and a systolic-to-diastolic shift of shunting across the ductus arteriosus after birth is unknown. To address this question, ductal and aortic isthmus flows were measured with high-fidelity transit-time probes in six anesthetized preterm fetal lambs before and after cord clamping and subsequent early mechanical ventilation and for 30 min postbirth...
February 15, 2016: Journal of Applied Physiology
Bhawna Arya, Aarti Bhat, Margaret Vernon, Jeffrey Conwell, Mark Lewin
OBJECTIVES: Prenatal diagnosis of neonatal coarctation of the aorta (CoA) is challenging; there is a high false-positive rate, yet 60-80% are not identified prenatally. We aimed to identify novel fetal echocardiographic measures to improve prenatal identification of CoA. METHODS: A retrospective review was conducted of subjects seen from 1/2007-1/2014 with prenatal suspicion for CoA and postnatal follow-up. The last fetal echocardiogram prior to delivery was evaluated for right/left ventricular dimensions, ascending (AAo), transverse (TAo), descending aorta (DAo), aortic isthmus (AoI), ductus arteriosus (DA), and main pulmonary artery diameters, and AoI and DA spectral Doppler...
February 2016: Prenatal Diagnosis
Jeffrey D Crawford, Cindy M Hsieh, Ryan C Schenning, Matthew S Slater, Gregory J Landry, Gregory L Moneta, Erica L Mitchell
We present a case of familial thoracic aortic aneurysm and dissection (FTAAD) in a pregnant female. FTAAD is an inherited, nonsyndromic aortopathy resulting from several genetic mutations critical to aortic wall integrity have been identified. One such mutation is the myosin heavy chain gene (MYH11) which is responsible for 1-2% of all FTAAD cases. This mutation results in aortic medial degeneration, loss of elastin, and reticulin fiber fragmentation predisposing to TAAD. Aortic disease is more aggressive during pregnancy as a result of increased wall stress from hyperdynamic cardiovascular changes and estrogen-induced aortic media degeneration...
January 2016: Annals of Vascular Surgery
Yen K Bui, Lisa W Howley, Steven E Ambrose, Henry L Galan, Timothy M Crombleholme, Julia Drose, John Bokowski, Bettina F Cuneo
OBJECTIVES: "Heart sparing" refers to prominent antegrade fetal coronary artery (CA) blood flow readily visualized by color Doppler and is a harbinger of poor outcome in growth restricted fetus, but little is known of the features and presentation of heart sparing in normally grown fetuses. Our objective was to describe heart sparing effects in normally grown fetuses, and compare the presentation and outcome of heart sparing between fetuses with growth restriction and those who were normally grown...
2016: Journal of Maternal-fetal & Neonatal Medicine
Gülşah İlhan, Ahmet Cem İyibozkurt, Halil İbrahim Kalelioğlu, Lemi İbrahimoğlu, Ali Galip Zebitay, Meryem Kürek Eken, Ayşe Filiz Gökmen Karasu
PURPOSE: To demonstrate the blood flow profiles of fetuses with cardiac anomalies at the level of Ductus venosus (DV) and Aortic isthmus (AI) to evaluate the effects of fetal cardiac anomalies on these profiles, and how these profile changes contribute to cardiac anomaly screening studies as a marker. METHODS: DV and AI doppler studies were applied to 64 singleton pregnant women with fetal cardiac anomalies and 74 pregnant women with healthy fetuses. DV-PVIV (peak velocity index for veins) for DV and IFI (isthmic flow index) for AI were used...
February 2016: Archives of Gynecology and Obstetrics
Seçil Kurtulmuş, Esra Bahar Gür, Deniz Öztekin, Ebru Şahin Güleç, Duygu Okyay, İbrahim Gülhan
OBJECTIVE: The aim of this study was to evaluate changes in fetal cardiac and peripheral circulation in pregnancies complicated with intrahepatic cholestasis. MATERIAL AND METHODS: The Doppler examination results of 22 pregnant subjects complicated with intrahepatic cholestasis of pregnancy (ICP) and 44 healthy controls were compared. The parameters of fetal cardiac circulation were pulmonary artery and aortic (Ao) peak systolic velocity (PSV), pulmonary vein (Pv), peak velocity index (PVI) and pulsatility index (PI), mitral valve (MV) and tricuspid valve (TV), early diastole (E)- and atrial contraction (A)-wave peak velocity ratio (E/A), and isthmus aortic peak systolic velocity (IAo PSV)...
2015: Journal of the Turkish German Gynecological Association
R Cruz-Martinez, V Tenorio, N Padilla, F Crispi, F Figueras, E Gratacos
OBJECTIVE: To estimate the value of gestational age at birth and fetal Doppler parameters in predicting the risk of neonatal cranial abnormalities in intrauterine growth-restricted (IUGR) fetuses born between 28 and 34 weeks' gestation. METHODS: Fetal Doppler parameters including umbilical artery (UA), middle cerebral artery (MCA), aortic isthmus, ductus venosus and myocardial performance index were evaluated in a cohort of 90 IUGR fetuses with abnormal UA Doppler delivered between 28 and 34 weeks' gestation and in 90 control fetuses matched for gestational age...
October 2015: Ultrasound in Obstetrics & Gynecology
L Guedes-Martins, E Silva, A R Gaio, J Saraiva, A I Soares, J Afonso, F Macedo, H Almeida
Blood flow assessment employing Doppler techniques is a useful procedure in pregnancy evaluation, as it may predict pregnancy disorders coursing with increased uterine vascular impedance, as pre-eclampsia. While the local causes are unknown, emphasis has been put on reactive oxygen species (ROS) excessive production. As NADPH oxidase (NOX) is a ROS generator, it is hypothesized that combining Doppler assessment with NOX activity might provide useful knowledge on placental bed disorders underlying mechanisms...
August 2015: Redox Biology
Shanthi Sivanandam, Jessica Nyholm, Andrew Wey, John L Bass
Antenatal diagnosis of right heart enlargement has a wide spectrum of differential diagnosis from maternal, placental and fetal causes, and outcomes of all are not known. Coarctation of the aorta is in the differential diagnosis of right heart enlargement. In our study, we focused to measure multiple cardiac dimensions in fetuses with right heart enlargement to identify the fetus with coarctation of the aorta utilizing echocardiographic measurements. Ten cardiovascular dimensions were measured from fetal studies between 20- and 34-week gestation, and six were measured on postnatal echocardiograms...
October 2015: Pediatric Cardiology
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