To evaluate the prenatal echocardiographic features, diagnostic accuracy, associated anomalies, and early postnatal outcomes of fetal aortic arch obstruction, focusing on differentiating interrupted aortic arch from coarctation of the aorta.
Approach:
Study Design: Retrospective analysis of 72 cases of aortic arch obstruction over a 10-year period, utilizing prenatal ultrasound and medical records.
Data Collection: Summarized ultrasound manifestations, genetic characteristics, combined malformations, and tracked perinatal and clinical outcomes.
Key Findings:
Prenatal diagnostic accuracy was 90.28%.
Intracardiac malformations occurred in 88.89% of cases, with the prevalence of combined anomalies significantly higher in IAA (p < 0.001).
IAA cases had significantly smaller aortic valve annulus Z-scores, ascending aorta Z-scores, and aortic-to-pulmonary artery diameter ratios but significantly larger left-to-right ventricular (LV-to-RV) diameter ratios compared to CoA (p < 0.05).
IAA was associated with more severe hypoxia and cyanosis and lower postoperative survival compared to CoA.
Interpretation:
Prenatal echocardiography is effective for detecting fetal aortic arch obstruction and differentiating IAA from CoA.
Limitations:
Study conducted at a single center, which may limit generalizability.
Retrospective design may introduce selection bias.
Conclusion:
Prenatal echocardiography is crucial for identifying aortic arch obstruction, with IAA linked to more complex anomalies and poorer outcomes.
