and Marcelo Zugaib4
(1)
São Paulo University, Bauru, Brazil
(2)
Parisian University, Bauru, France
(3)
Member of International Fetal Medicine and Surgery Society, Bauru, Brazil
(4)
Obstetrics, University of São Paulo, Bauru, Brazil
The incidence of congenital heart defects is in 8–10 per 1000 live births. With advances in fetal echocardiography, congenital heart defects are most frequently diagnosed in intrauterine life; however, there is still some difficulty for the noncardiologist sonographer to understand this small and complex organ.
Fig. 7.1
Anatomical normal heart in four-chamber view: the atrial chambers above the ventricles, the foramen ovale flap to the left atrium (4), the descending aorta next to the left atrium (1). The moderator band is in the right ventricle (3), which is more hypertrophic and more anterior in relation to the thorax. The implantation of the tricuspid valve is lower than the mitral valve (offset) (2)
Fig. 7.2
Normal three-vessel view: the superior cava vein is smaller than the aorta, which is smaller than the pulmonary artery. The trachea is a circular image between the superior vena cava and the aorta (1)
Fig. 7.3
Four-chamber view of a trabecular (muscular) ventricular septal defect (1)
Fig. 7.4
(a, b) Trabecular (muscular) ventricular septal defects (CIV) with color Doppler in a four chamber view of the fetal heart. AO aorta
Fig. 7.5
(a, b) Long-axis view of fetal heart in black and white on (a) showing the intact ventricular septum and the left ventricle outlet and with color Doppler on (b) (AO aorta, AE left atrium, SIV interventricular septum, VD right ventricle, VE left ventricle)
Fig. 7.6
Long-axis view, but showing the right ventricle outlet
Fig. 7.7
Short-axis view of the heart, without color Doppler, presenting the aortic valve (AO) in the middle, surrounded by the right atrium (AD), tricuspid valve (VT), right ventricle (VD), pulmonary valve (VP), and the pulmonary artery (AP). The extension of the left pulmonary artery is the ductal arch. It is still possible to view the left atrium (AE) and the atrial septum
Fig. 7.8
The same view presented in Fig. 7.7 now showed with color dopplervelocimetry. The large blue flow on the right part of the figure shows the pulmonary artery emerging from right ventricle
Fig. 7.9
The arterial ductal flow (ductus arteriosus), continued to the left pulmonary artery one can see that pulmonary artery ends in a right angle with the descending aorta
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