Objective: Left superior caval vein (LSVC) is reported in 0.3% to 0.5% of the population at autopsy. LSVC is easily recognised during fetal scanning but its significance is uncertain. We document the incidence, associations and outcome of LSVC in 1678 consecutive fetuses with suspected, or at increased risk of congenital heart disease (CHD) referred to a fetal medicine unit for echocardiography between 1997 and 2002. Methods: Systematic ultrasound examination was made using 5 transverse views (abdominal situs, 4 chamber, both outflow tracts and 3 vessel), colour flow mapping and pulsed Doppler. Diagnosis was confirmed by postnatal echocardiography, surgery or autopsy. Both the odds ratio (OR, 95% confidence intervals) for CHD in the presence of LSVC and the OR of the defect being coarctation (CoA) were calculated. Results: Four of the 1230 normal fetuses (0.3%) had a LSVC compared with 12/448 (2.7%) fetuses with CHD. Hence the OR for a cardiac defect if LSVC was detected is 8.43 (2.71, 26.29). Four of 16 fetuses (25%) with LSVC had extracardiac malformations and three (19%) aneuploidy. LSVC was present in 5 of 10 fetuses (50%) with CoA. The OR of the CHD being a CoA in fetuses with LSVC was 61.57 (14.48, 261.74). Conclusions: Persistent LSVC is not a benign finding in the fetus and is an indication for detailed echocardiography. It may aid in the diagnosis of fetal CoA.
P01.06: Significance of left superior caval vein in the fetus
FICHERA, Anna;
2004-01-01
Abstract
Objective: Left superior caval vein (LSVC) is reported in 0.3% to 0.5% of the population at autopsy. LSVC is easily recognised during fetal scanning but its significance is uncertain. We document the incidence, associations and outcome of LSVC in 1678 consecutive fetuses with suspected, or at increased risk of congenital heart disease (CHD) referred to a fetal medicine unit for echocardiography between 1997 and 2002. Methods: Systematic ultrasound examination was made using 5 transverse views (abdominal situs, 4 chamber, both outflow tracts and 3 vessel), colour flow mapping and pulsed Doppler. Diagnosis was confirmed by postnatal echocardiography, surgery or autopsy. Both the odds ratio (OR, 95% confidence intervals) for CHD in the presence of LSVC and the OR of the defect being coarctation (CoA) were calculated. Results: Four of the 1230 normal fetuses (0.3%) had a LSVC compared with 12/448 (2.7%) fetuses with CHD. Hence the OR for a cardiac defect if LSVC was detected is 8.43 (2.71, 26.29). Four of 16 fetuses (25%) with LSVC had extracardiac malformations and three (19%) aneuploidy. LSVC was present in 5 of 10 fetuses (50%) with CoA. The OR of the CHD being a CoA in fetuses with LSVC was 61.57 (14.48, 261.74). Conclusions: Persistent LSVC is not a benign finding in the fetus and is an indication for detailed echocardiography. It may aid in the diagnosis of fetal CoA.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
