وصف
Transposition of the Great Arteries (TGA) is a congenital heart defect in which the two main arteries, the aorta, and the pulmonary artery, are switched in their positions. Prenatal diagnosis of TGA is crucial as it allows for early intervention after birth. Routine fetal ultrasounds can provide the first clues. Suspicion arises when the normal cross over between the great arteries is not visualized. Blood flow patterns can be assessed with Doppler ultrasound. Other cardiac abnormalities might be detected during prenatal ultrasounds, such as a ventricular septal defect (VSD) often associated with TGA.
ملخص
- Prenatal diagnosis of transposition of the great arteries (TGA) hinges on recognizing abnormal features compared to a normal fetal heart. This veterinary cognition, the ability to distinguish normal from abnormal, is crucial for accurate diagnosis. The key lies in training the eye to identify deviations from the typical anatomy.
- Fetal heart examination uses either a "sweet technique" (sweeping the transducer upwards) or a "rotational technique" (focusing on the aorta's course towards the right shoulder). While the sweet technique is easier, the rotational technique is considered superior for comprehensive assessment.
- Normal fetal heart anatomy features the superior and inferior vena cava draining into the right atrium, which connects to the right ventricle. The pulmonary artery originates from the right ventricle, while the aorta originates from the left ventricle. In TGA, the pulmonary artery and aorta are switched, resulting in ventriculo-arterial discordance.
- In a normal heart, the great vessels cross over each other at their origin. In TGA, the great vessels run parallel to each other instead of crossing. This difference in orientation is a key diagnostic clue. Distal parallel orientation with an aortic arch is a normal variant (V-sign) and should not be mistaken for TGA.
- Visualizing the three-vessel view normally shows the pulmonary artery, aorta, and superior vena cava. In TGA, only two vessels may be seen, with the aorta positioned anteriorly and to the right, assuming its normal arching pattern, unlike the pulmonary artery in a normal heart.
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