우수논문상(모체태아의학) = Prenatal diagnosis of atrial isomerism in the Korean population

다국어 초록 (Multilingual Abstract)

Objective: To report our experiences in the prenatal diagnosis of atrial isomerism and postnatal outcomes. Methods: A total of 80 fetuses prenatally diagnosed with atrial isomerism were retrospectively analyzed between 1999 and 2011 at a single institution. Results: Of 43 fetuses with prenatally diagnosed right atrial isomerism (RAI), 40 cases were analyzed. The diagnostic accuracy was 93%. The main intracardiac anomalies in RAI were atrioventricular septal defect (AVSO), abnormal pulmonary venous connection, bilateral superior vena cava (BSVC), and pulmonary atresia. Among 28 live births, three infants were lost to follow up, and the overall survival rate was 60%. Of 37 fetuses with prenatally diagnosed left atrial isomerism (LAI), 35 were evaluated. The diagnostic accuracy was 97%. The main intracardiac anomalies in LAI were ventricular septal defect, BSVC, AVSD, double outiet right ventricle, and bradyarrhythmia. Among seven patients with bradyarrhythmia, only one showed a complete atrioventricular block. All fetuses had an interrupted inferior vena cava with azygous continuation. The overall survival rate was 90%. Conclusion: Our study confirms the previous findings of fetal atrial isomerism. We also demonstrates a much lower prevalence of AVSO and complete heart block In LAI and a better survival rate in RAI. Although the postnatal outcomes lor RAI were worse than those for LAI, successful postnatal surgery with active management improved the survival rate.