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. 2021 Aug;41(9):1127-1133.
doi: 10.1002/pd.6007. Epub 2021 Jul 8.

Dilated ascending aorta in the fetus

Ioana Dumitrascu-Biris  1   2 , Vita Zidere  1   2 , Trisha Vigneswaran  1   2 , Marietta Charakida  1   2   3 , Sujeev Mathur  1 , Nick Kametas  2 , John Simpson  1   2   3
Affiliations

Dilated ascending aorta in the fetus

Ioana Dumitrascu-Biris et al. Prenat Diagn. 2021 Aug.

Abstract

Introduction: Prenatal recognition of dilated aortic root is extremely rare and there are significant challenges in counselling these patients. The primary aim of this case series is to describe the prevalence, associations and outcome of dilated ascending aorta diagnosed during fetal life.

Methods: This is a retrospective cohort study from two tertiary fetal cardiology centres. Dilated ascending aorta was defined as gestation-specific standard deviation > 1.96 at some point during gestation.

Results: Sixteen infants were live born and underwent postnatal echocardiography. Prenatally suspected bicuspid aortic valve (BAV) (n = 6) was confirmed in 5 cases (83%) postnatally. Thirteen children have been followed up for a period of minimum one year. No connective tissue disease was found.

Conclusions: Prenatal dilated ascending aorta is a rare finding (0.06%). It is associated with BAV in 37% of cases and extracardiac abnormalities in 15.7%. Nuchal translucency measurement was >3.5 in 13% of cases. Connective tissue disease was not diagnosed postnatally. This is the largest prenatal cohort with dilated ascending aorta and postnatal outcomes to date. We showed a postnatal persistence of ascending aortic dilatation in 43% of babies. In the absence of extra-cardiac abnormalities, medium term outcome appears good but postnatal surveillance of aortic dilation is required.

Keywords: aortic annulus; bicuspid aortic valve; congenital heart disease; dilated ascending aorta; fetus.

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References

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