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European Heart Journal Advance Access published online on May 8, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn194
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Foetal echocardiographic assessment of tetralogy of Fallot and post-natal outcome

Florentia Kaguelidou1,2, Laurent Fermont3, Younes Boudjemline1, Jérôme Le Bidois3, Alain Batisse3 and Damien Bonnet1,*

1 Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Université Paris V-Descartes, AP-HP, Hôpital Necker-Enfants Malades, 149, rue de Sèvres, 75015 Paris, France
2 INSERM CIE 5, Clinical Epidemiology Unit, AP-HP, Hôpital Robert Debré, Paris, France
3 Institut de Puériculture de Paris, Paris, France

Received 15 September 2007; revised 28 March 2008; accepted 17 April 2008; online publish-ahead-of-print 1 January 2008.

* Corresponding author. Tel: +33 1 44 49 43 44, Fax: +33 1 44 49 43 40, Email: damien.bonnet{at}nck.aphp.fr

See page 1344 for the editorial comment on this article (doi:10.1093/eurheartj/ehn200)

Aims: Outcome of foetuses diagnosed with tetralogy of Fallot (TOF) or pulmonary atresia with ventricular septal defect (PA-VSD) and the reliability of foetal echocardiography to predict post-natal surgical outcome.

Methods and results: Outcome of 218 foetuses having been diagnosed with TOF (n = 153) or PA-VSD (n = 65) was reviewed. Abnormal karyotyping, 22q11 deletion, and extracardiac anomalies were found, respectively, in 11, 18, and 46%. Pregnancy was terminated in 75 cases (34%), and in three cases foetuses died in utero. Presence or absence and confluence of PA branches were confirmed after birth or pregnancy termination in all but five (5%) cases. Main pulmonary trunk (MPA) was incorrectly described in 11 (10%) cases and major aorto-pulmonary collateral arteries in 16 (13%) cases. Among live born infants, 110 (88%) were operated and 92 (74%) underwent complete repair in the first year of life. Size of confluent PAs and presence of MPA were related to the probability of having a complete repair in the first year of life.

Conclusion: Foetal diagnosis of TOF and PA-VSD has a major impact on pregnancy outcome, as associated anomalies are frequently found. Pre-natally determined size of PA branches and presence of MPA are good predictors of complete repair in the first year of life.

Key Words: Tetralogy of Fallot • Foetus • Heart defects • Congenital • Echocardiography • Outcome


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N. M.S. de Groot and M. J. Schalij
Foetal echocardiography: tool to predict the future of patients with congenital heart defects?
Eur. Heart J., June 1, 2008; 29(11): 1344 - 1345.
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