Prenatal Diagnosis of Congenital Cardiac Anomalies: A Practical Approach Using Two Basic Views
Movie 1.
US cine clip of a normal fetal heart, with the fetus in cephalic presentation. The spine is at the 4 o'clock position, and the interventricular septum is at the 9 o'clock position. The normal four chambers of the heart are seen initially. The clip then progresses to the base view of the heart, and the normal crossing of the pulmonary artery over the aorta can be seen. Finally, the left ventricular outflow tract and the ascending aorta are visualized.
Movie 2. US cine clip demonstrates a transverse view of the fetal chest, with the fetus in cephalic presentation. The spine is at the 1 o'clock position, and the interventricular septum is at the 5 o'clock position. The clip initially shows the normal appearing four-chamber view of the fetal heart and progresses to demonstrate the pulmonary artery coming from the left ventricle. The clip then shows the aorta arising from the right ventricle, with the pulmonary artery again identified. Finally, the four chambers of the heart are again seen. Note that the pulmonary artery never crosses over the aorta.
Movie 3. US cine clip demonstrates tetralogy of Fallot. The fetus is in cephalic presentation, with the spine at the 4 o'clock position and the interventricular septum at approximately the 8 o'clock position. Initially, the base view of the heart shows a small pulmonary artery bifurcating into the right pulmonary artery and the ductus arteriosus. The scan then shows the large, overriding aorta, followed by the four-chamber view. A VSD and right ventricular hypertrophy are noted on the four-chamber view. Finally, the small pulmonary artery is visualized again.
