Left top cava vena persistence: ecocardiographical marker of hearty and extra cardiacas fetal malformations

Abstract

Introduction: Persistentleft upper vena cava (VSIP) is the most common congenital vascular malformation, observed in 0.3% of autopsies in the general population and 4-8 % of patients with congenital heart disease.

During early embryological development the venous return of the head and arms normally drains into the right atrium by the left and right upper cardinal veins.

Objective: Relate the Persistence of Vena Cava Superior Left (VCSIP) diagnosed by fetal echocardiographic study, with the presence of intraandal abnormalities.

Methodology: A descriptive, retrospective study is carried out in 75 cases obtained from the database of the Department of Perinatal Medicine of the Hospital Universitario La Paz (Madrid –Spain), during the period between 2006 -2017 with prenatal diagnosis of (VCSIP). Echocardiographic studies at 32 amniocentesis and 2 chorionic rate biopsies are performed onall 75 patients and, whether or not, related to congenital cardiac abnormalities and extracardiac defects are established. Statistical analysis is performed using the STATA program.

Result: 75 fetuses diagnosed with VcSIP were ultrasoundd, with an averagegestational age at diagnosis of 26.6 weeks (DE: 5.87; IC: 95%). In 14 patients (18.67%) no malformations were detected; 27 patients (36%) cardiac abnormalities were evident; 15 patients (20%), had extra cardiac malformations and 19 patients (25.33%), had extra and intracardiac malformations.

Conclusions: Prenatal ultrasound has a major impact for early diagnosisof anatomical effects and variations such as the upper left vena cava. Diagnosis of this alteration requires desperation and monitoring of other associated foetal abnormalities, whether intra and extra-cardiac. With good prenatal ultrasound screening it would not be imperative to indicate to patients with isolated VcSIP an invasive prenatal test.