Figures
Fig. 1: Coarctation of the aorta at 24 completed weeks with STIC volume reconstruction and automatic labeling using the FINE method. In the 3-vessel-trachea view, the size of the transverse aorta is clearly reduced. The 4-chamber view is abnormal with ventricular asymmetry (LV<RV), and the size of the foramen ovale is normal. In both the 5-chamber view (5CV) and left ventricular outflow tract (LVOT) view, there is a smaller ascending aorta corresponding to an aortic coarctation. Additionally, a perimembraneous outlet VSD is seen. The RVOT view shows a normal main pulmonary artery and bifurcation. There is a regularly filled stomach in the abdominal plane. The ductal arch view is normal. In contrast, the aortic arch is thinned, which confirms the finding of an obstructed LVOT. The RA appears to be enlarged. The vena cava view denotes similar findings.
A - transverse aortic arch; Ao - aorta; Desc - descending; IVC - inferior vena cava; LA - left atrium; LV - left ventricle; P - pulmonary artery; PA - pulmonary artery; RA - right atrium; RV - right ventricle; RVOT - right ventricular outflow tract; S - superior vena cava; SVC - superior vena cava; Trans - transverse.
Fig. 2: Aortic stenosis at 27 gestational weeks. The 3VT view is rather normal. In contrast, the LV is considerably larger than the RV, and the interventricular septum is bulging toward the right side. The cardiac axis is within the normal range. Both atria are normal in size and shape. The ascending aorta shows a thickened, nondisappearing valve during systole, and the mitral valve leaflets also appear thickened. The ductal arch, aortic arch and bicaval views are normal.
Fig. 3: Aortic atresia seen at 23 weeks causing a hypoplastic left heart with functional univentricular circulation. The left-sided cardiac structures are markedly smaller than those on the right side. The transverse aorta can barely be seen in the 3VT plane; accordingly, the ascending aorta in the 5CV and LVOT planes is extremely small. The residual LV has a slit-like appearance, and both atria and the tricuspid valve are normal in size. There is a miniaturized mitral valve. The RVOT, ductal arch and bicaval views are normal. The aortic arch is hypoplastic.
Fig. 4: Fetus with a hypoplastic left heart at 23 weeks. The characterizing anatomic features are clearly depicted after semiautomatic reconstruction using FINE. There is a size discrepancy in both great vessels on the 3-vessel-trachea view (PA>Ao). The 4CV view is abnormal with a ventricular asymmetry (LV<RV), the LV is round and hypocontractile with endocardial fibroelastosis, and the foramen ovale is patent and nonrestrictive. Both the mitral valve and the ascending aorta are small (5CV, LVOT). The RVOT views shows normal main and branch pulmonary arteries. The ductal arch view is normal, while the aortic arch is thinned, which confirms the finding of an obstructed LVOT. The RA appears to be enlarged. The vena cava view denotes similar findings.
Fig. 5: Two cases of a double-inlet left ventricle (DILV) at 26 and 22 completed gestational weeks. FINE application shows normally related great vessels in panel a (3VT, LVOT, RVOT and arch views). Both AV valves are connected to the anatomical LV, and the RV is small but normally situated to the right of the dominant ventricle. The ascending aorta in the LVOT and 5CV planes is normal in size. The RVOT view shows the small RV giving rise to the main pulmonary artery. The longitudinal ductal and aortic arch and bicaval views are normal. The rather rare variant corresponds to so-called Holmes’ heart. Panel b depicts the more common type of DILV with ventriculoarterial discordance and an extremely small RV giving rise to the anteriorly dislocated ascending aorta (LVOT, aortic arch view). The main pulmonary artery is severely stenotic (3VT, ductal arch view). The bicaval arrangement appears to be normal.