Foetal echocardiographic assessment of tetralogy of Fallot and post-natal outcome.
OBJECTIVE
Outcome of foetuses diagnosed with tetralogy of Fallot (TOF) or pulmonary atresia with ventricular septal defect (PA-VSD) and the reliability of foetal echocardiography to predict post-natal surgical outcome.


RESULTS
Outcome of 218 foetuses having been diagnosed with TOF (n = 153) or PA-VSD (n = 65) was reviewed. Abnormal karyotyping, 22q11 deletion, and extracardiac anomalies were found, respectively, in 11, 18, and 46%. Pregnancy was terminated in 75 cases (34%), and in three cases foetuses died in utero. Presence or absence and confluence of PA branches were confirmed after birth or pregnancy termination in all but five (5%) cases. Main pulmonary trunk (MPA) was incorrectly described in 11 (10%) cases and major aorto-pulmonary collateral arteries in 16 (13%) cases. Among live born infants, 110 (88%) were operated and 92 (74%) underwent complete repair in the first year of life. Size of confluent PAs and presence of MPA were related to the probability of having a complete repair in the first year of life.


CONCLUSIONS
Foetal diagnosis of TOF and PA-VSD has a major impact on pregnancy outcome, as associated anomalies are frequently found. Pre-natally determined size of PA branches and presence of MPA are good predictors of complete repair in the first year of life.
Kaguelidou
Florentia
F
Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Université Paris V-Descartes, AP-HP, Hôpital Necker-Enfants Malades, 149, rue de Sèvres, 75015 Paris, France.
Fermont
Laurent
L
Boudjemline
Younes
Y
Le Bidois
Jérôme
J
Batisse
Alain
A
Bonnet
Damien
D
D000293:Adolescent; D000328:Adult; D042241:Early Diagnosis; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging* / Q000196:embryology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D018633:Pulmonary Atresia / Q000000981:diagnostic imaging* / Q000196:embryology; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging* / Q000196:embryology; D016216:Ultrasonography, Prenatal / Q000379:methods*