Murat MUHCU, Ali BABACAN, Nuri KAYA, İlhami GÜL, Selami SÜLEYMANOĞLU, Ercüment MÜNGEN, Yaşam Kemal AKPAK

İzole sağ arkus aorta: Antenatal değerlendirilmesi

Aortik ark anomalileri, konjenital kardiyak hastalıklar arasında prenatal olarak tanısı nadir konan bir anomalilerdir. Prenatal dönemde tespit edilen sağ aortik ark (SAA), özellikle trakeal veya özefageal kompresyon, 22q11 mikrodelesyonları, kardiyak ve/veya ekstra kardiyak malformasyonlarla izlenebilmektedir. Fetüsün intrauterin ve postnatal sağkalımı bu anomalilerin etkilerine bağlıdır. Özellikle SAA olmak üzere aortik ark varyasyonlarının fetal ekokardiyografi ile başarılı bir şekilde tanısı konabilmektedir. Tüm SAA olgularında Doppler ultrason kullanarak hem kardiyak hem ektrakardiyak çok detaylı değerlendirme yapılmalıdır. Ayrıca 22q11 mikrodelesyonlarının tespiti için sitogenetik analiz dikkatlice değerlendirilmelidir. Yinede izole SAA'nın iyi bir prognozunun olduğu ve çoğu hastada kromozomal anomali riskinin nispeten düşük olduğu asemptomatik vasküler bir varyant olduğu akılda tutulmalıdır. Bu yazıda, fetal dönemde tespit edilen bir SAA olgusunun prenatal bulgularını, birlikte olduğu durumları ve prognozunu literatür ışığında değerlendirmeyi amaçladık.

Isolated right aortic arch: Antenatal evaluation

Aortic arch abnormalities are the least frequently prenatally diagnosed congenital cardiac abnormalities. Right aortic arch (RAA) identified in prenatal period is associated frequently with other cardiac/non-cardiac malformations, notably tracheal or esophageal compression and microdeletions 22q11. Intrauterine and postnatal survey of the fetus depends on these anomalies and their effects. Aortic arc variations, particularly RAA, can be diagnosed accurately by fetal echocardiography. Elaborated fetal cardiac and extracardiac evaluation should be undertaken in all cases of RAA by using Doppler ultrasound. Also cytogenetic testing for 22q11 microdeletions should be considered carefully. Nonetheless, it should be kept in mind that isolated RAA has a good prognosis, and in the majority of the patients, it is an asymptomatic vascular variant with a relatively low risk for chromosomal anomaly. In this paper with this case, we aim to evaluate the prenatal findings, associated conditions and prognosis of prenatally detected RAA anomalies in the light of literatures. J Clin Exp Invest 2015; 6 (2): 192-195.

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