Right atrial isomerism diagnosed by STIC-HD live flow and autopsy: A case report. Issue 8 (26th February 2021)

• Record Type: Journal Article
• Authors: Yang, Linhua; Zhou, Liuying; Chen, Lin
• Other Names: Saranathan. Maya section editor.
• Is Part Of: Medicine. Volume 100:Issue 8(2021)
• Publication Date: 2021-02-26
• Subjects: autopsy -- diagnose -- right atrial isomerism -- STIC-HD live flow; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000024912
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Right atrial isomerism (RAI) is one of the most severe forms of congenital heart disease. This case of RAI was so complex that it incorporated 7 heart defects. It can be challenging to display the spatial relationship between different anatomical structures using conventional two-dimensional and color ultrasound (2D-Doppler imaging); therefore, we used spatio-temporal image correlation (STIC) and high definition live flow imaging technology to vividly display this case of RAI in a stereoscopic mode. Patient concerns: A 24-year-old woman was referred to our tertiary center at 24 weeks of gestation. The woman had difficult conceiving. Once pregnant, she was opposed to abortion, even if there was a possibility of deformity. Diagnosis: The fetus presented with an atrioventricular septal defect, persistent left superior vena cava, supra-cardiac total anomalous pulmonary venous connection (TAPVC), double outlet right ventricle, right ductus arteriosus, right aortic arch (RAA) with mirror image branching, and aortic arch dysplasia. Interventions: After consulting a pediatric cardiologist, the woman requested an abortion and consented to an autopsy. Outcomes: Autopsy supported the echocardiographic findings. Lessons: Accurate diagnosis of RAI is essential for clinical and parent decision making. 2D-Doppler imaging combined with STIC-HD live flow can be used to visualize the spatial morphology of blood vessels, including the cardiac chambers and great vessels of the fetal heart, and smaller peripheral vessels.