Chẩn đốn phân biệt Mất cân đối buồng tim

Một phần của tài liệu Bài giảng siêu âm tim thai trong dự đoán nguy cơ hẹp eo động mạch chủ sau sinh (Trang 38 - 41)

Mất cân đối buồng tim

– Các BTBS khác

• HL TMP BT• TT TMCT T • TT TMCT T • ?TLT cơ bè

– Mạch máu / ngồi tim

• Khơng OTM • Co thắt OĐM • Thốt vị hồnh • Dị dạng TM Galen • Thiếu máu; IUGR

– Di truyền khác

• T21, XO,khác

– Bình thường/ SL 3 tháng cuối

Persistence of a left superior vena cava (LSVC) draining to the coronary

In a meta-analysis which included over 500 fetuses, CoA was

associated with isolated LSVC in 21% of cases. However, another meta-analysis found that it did not carry an increased risk for CoA.

In interruption of the inferior vena cava (IVC), the Theoretical

decreased blood flow across the patent foramen ovale may result in a decrease in left ventricular cardiac output and secondary IST hypoplasia.

• Total anomalous pulmonary venous connection decreases the

amount of prograde flow through the left heart, which may result in hypoplasia of the left heart structures and aortic arch.

• Structural abnormalities of the MV will decrease LV inflow and

cardiac output, resulting in decreased blood flow to the IST.

• A large ventricular septal defect, Posterior malalignment and some

degree of hypoplasia of the aortic valve annulus will further contribute to left to right shunting across the VSD and more significant arch hypoplasia.

• A bicuspid or structurally abnormal aortic valve a meta-analysis

failed to show that a bicuspid aortic valve carried an increased risk for CoA in utero.

Turner syndrome is associated with CHD, most commonly a

bicommissural aortic valve (16%), CoA (11%)

• Cerebral vein of Galen malformations result in increased blood flow

to the head and a relative decrease in blood flow across the aortic IST. There have been case reports where Vein of Galen malformations

Một phần của tài liệu Bài giảng siêu âm tim thai trong dự đoán nguy cơ hẹp eo động mạch chủ sau sinh (Trang 38 - 41)

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