Prenatal ultrasonographic features of fetal total anomalous pulmonary venous connection

Objective To investigate the prenatal ultrasonographic features of fetal total anomalous pulmonary venous connection (TAPVC). Methods Forty-one cases who received prenatal ultrasound examination and then were diagnosed with TAPVC by postnatal surgery at the Third Affiliated Hospital of Zhengzhou University from June 2013 to June 2018 were enrolled. Echocardiography findings of all cases were analyzed retrospectively, and the prenatal imaging features were summarized. Results Among all cases, 21 were confirmed as supracardiac type, 14 as intracardiac type, four as infracardiac type and two as mixed type after surgery. The echocardiographic features of TAPVC were as follows: all 41 cases showed smooth posterior wall of left atrium without visible part of pulmonary venous connected to the left atrium in the-four chamber view; in 33 cases, the space between left atrium and descending aorta was widened and the pulmonary venous confluence was observed in the four-chamber view; ten cases showed a dilated coronary sinus in the four-chamber view and 27 cases showed vertical vein in the three vessels and trachea or the upper abdomen view. None of the 41 cases was complicated by other structural intracardiac abnormalities. However, seven cases were complicated by obstruction of blood flow, and the blood flow velocity measured by Doppler ultrasound was 0.76 m/s to 1.25 m/s. Conclusions Blood flow in pulmonary veins should be carefully observed in prenatal ultrasonography, and anomalous pulmonary venous connection should be considered when pulmonary veins do not connect to the left atrium. Key words: Pulmonary veins; Congenital abnormalities; Scimitar syndrome; Ultrasonography, prenatal