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Title of Journal: Pediatr Cardiol

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Abbravation: Pediatric Cardiology

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Springer US

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DOI

10.1016/0020-7381(76)80028-9

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1432-1971

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Association of A Dilated Coronary Sinus in the Fet

Authors: Prema Ramaswamy Daniela Rafii Marina Osmolovsky Arpit Agarwal Cynthia Amirtharaj
Publish Date: 2016/08/24
Volume: 37, Issue: 8, Pages: 1562-1568
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Abstract

Evidence suggests an association between left heart obstructive lesions and dilated coronary sinus DCS but this has not been studied in fetuses A retrospective review of fetal echocardiograms FE over an 8year period was conducted and patients with DCS were identified and confirmed postnatally There were 5840 FE performed on 4920 women during this period Of 49 patients with DCS 22 had normal intracardiac anatomy and 27 patients had congenital heart disease CHD yielding an incidence of 46  in the presence of CHD 27/584 Of 27 patients with DCS and CHD approximately a third had either hypoplastic left ventricles and/or coarctations 10/27 37  The incidence of left heart obstructive lesions was much higher in the presence of a DCS 37  vs 45/557 8  p  00001 The odds ratio of left heart hypoplasia in fetuses with CHD and a DCS was 66 95  CI 28–153 Comparison of patients with postnatally confirmed coarctation with those with normal intracardiac anatomy with DCS revealed that in the former the right ventricle p = 0005 pulmonic valve annulus p = 00001 and the tricuspid inflow were larger p = 0001 compared to corresponding leftsided structures The size of the DCS was not significantly different between the two groups but in the former the DCS was more closely related to the posterior leaflet of the mitral valve and caused a significant diminution of the mitral inflow Our study suggests a strong association possibly causal between left heart obstructive lesions and DCS in utero

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