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Book Details
Abstract
Fetal Cardiovascular Imaging, edited by Drs. Rychik and Tian, is the most complete video atlas available in this field – providing the detailed visual guidance you need to successfully identify a full range of fetal heart disorders. Complied by the team at the Cardiac Center at Children’s Hospital in Philadelphia, this Expert Consult site and accompanying atlas-style text guide the acquisition and interpretation of fetal images for accurate diagnosis and effective management. Vivid color images, drawings, pathologic specimens and diagnostic algorithms facilitate tracking the progress of development of over 100 fetal heart problems.
- Enhance your cardiac imaging skills with a video library demonstrating imaging of the normal heart, and the imaging presentation of more than 100 different fetal heart problems.
- Recognize potential problems using views of the normal heart in development for comparative diagnosis.
- Get comprehensive coverage of cardiac anatomy, pathophysiology, natural history and disease management.
See developing and existing problems as they appear in practice thanks to an abundance of vivid color images, drawings, pathologic specimens, and diagnostic algorithms.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Fetal Cardiovascular Imaging: A Disease Based Approach | i | ||
| Copyright Page | iv | ||
| Contributors | v | ||
| Preface | vii | ||
| Acknowledgments | ix | ||
| Acknowledgments | xi | ||
| Foreword | xiii | ||
| Table Of Contents | xv | ||
| I Introduction | 1 | ||
| 1 The Fetal Circulation | 1 | ||
| Introduction | 2 | ||
| Ductus Venosus, Hepatic Circulation, and Inferior Vena Cava | 3 | ||
| Foramen Ovale | 4 | ||
| Ductus Arteriosus | 4 | ||
| Aortic Isthmus | 4 | ||
| Pulmonary Trunk and Right-sided Dominance | 5 | ||
| Placental Development and Physiology | 5 | ||
| References | 6 | ||
| 2 Embryology of the Cardiovascular System | 9 | ||
| Early Cardiogenesis | 10 | ||
| Cardiac Looping | 11 | ||
| Septation | 11 | ||
| Atrial and Canal Septation | 11 | ||
| Ventricular Septation | 12 | ||
| Outflow Tract Septation | 13 | ||
| Arch Artery Formation and Maturation | 13 | ||
| Venous Development | 13 | ||
| Later Cardiovascular Development | 15 | ||
| Suggested Readings | 16 | ||
| 3 The Fetal Cardiovascular Examination | 17 | ||
| What Is Needed, Indications, and Modalities of Fetal Echocardiography | 18 | ||
| Indications for Fetal Echocardiography | 19 | ||
| Modalities of Fetal Echocardiography | 19 | ||
| Two-dimensional Imaging | 19 | ||
| Doppler Echocardiography | 20 | ||
| Color Flow Imaging | 22 | ||
| The Strategy and Approach to Fetal Cardiovascular Imaging | 22 | ||
| Umbilical Cord, Fetal Biometry, Position of Fetus, Abdominal Situs, Cardiac Position, and Heart Size | 23 | ||
| Four-chamber Apical View | 23 | ||
| Ventricular Long-axis View and Sweep | 26 | ||
| Cardiac Short-axis View and Sweep | 27 | ||
| Caval Long-axis View | 29 | ||
| Ductal and Aortic Arch Views | 29 | ||
| Three-vessel View and Cephalad Sweep | 31 | ||
| Applications of Doppler Echocardiography: Sites Evaluated, Information Learned | 33 | ||
| Atrioventricular Valve and Ventricular Inflow | 34 | ||
| Hepatic Veins and Inferior Vena Cava Flow | 35 | ||
| Ductus Venosus | 35 | ||
| Umbilical Cord: Umbilical Vein and Umbilical Artery | 37 | ||
| Middle Cerebral Artery | 38 | ||
| Maternal Uterine Artery | 38 | ||
| Ductus Arteriosus | 39 | ||
| Aortic Isthmus | 39 | ||
| Pulmonary Veins | 40 | ||
| Applications of Echocardiography: Understanding Abnormal Hemodynamic States and Myocardial Dysfunction | 41 | ||
| Doppler Tissue Imaging | 41 | ||
| Ratio of Umbilical Artery—to–Middle Cerebral Artery Pulsatility Index | 43 | ||
| Pulmonary Vasoreactivity in Response to Maternal Hyperoxygenation | 46 | ||
| Cardiac Function: Myocardial Performance Index | 47 | ||
| Cardiac Function: Cardiac Output | 48 | ||
| Cardiac Function: Speckle Tracking and Myocardial Deformation Analysis | 49 | ||
| Cardiac Function: The Cardiovascular Profile Score | 50 | ||
| Timing of Fetal Cardiovascular Imaging: The Early Scan | 50 | ||
| References | 51 | ||
| 4 Three- and Four-Dimensional Imaging in Fetal Echocardiography | 53 | ||
| Introduction | 54 | ||
| Volume Acquisition | 54 | ||
| Spatiotemporal Image Correlation | 54 | ||
| B-Flow | 54 | ||
| Doppler Applications | 54 | ||
| Post-processing Applications | 55 | ||
| Multiplanar Reconstruction | 55 | ||
| Three-Dimensional Rendering | 55 | ||
| Tomographic Ultrasound Imaging | 56 | ||
| Virtual Organ Computer-Aided Analysis | 56 | ||
| Inversion Mode | 56 | ||
| The Methodology of 3D/4D Fetal Echocardiography | 57 | ||
| Planes and Virtual Planes in Fetal Echocardiography | 57 | ||
| Applying 3D/4DUS to Fetal Echocardiography | 58 | ||
| Multiplanar Reconstruction and Tomographic Ultrasound Imaging | 58 | ||
| 3D Rendering | 60 | ||
| B-Flow | 62 | ||
| 3D/4DUS for Fetal Cardiac Functional Assessment | 64 | ||
| Minimal Projection Mode | 64 | ||
| Cautions and Pitfalls | 64 | ||
| Accuracy of 3D/4DUS in Fetal Echocardiography | 65 | ||
| References | 66 | ||
| 5 Prenatal Practice Care Model and Delivery of the Fetus with Cardiovascular Disease | 67 | ||
| The Fetal Heart Program Practice Care Model | 68 | ||
| Measuring the Impact of a Prenatal Heart Defect: The Fetal Cardiovascular Disease Severity Grading Scale | 68 | ||
| The Transition from Fetus to Neonate: A Delivery Classification System | 70 | ||
| Reference | 72 | ||
| 6 Counseling and Support for the Family Carrying a Fetus with Cardiovascular Disease | 73 | ||
| Principles of Prenatal Counseling for Fetal Cardiovascular Disease | 74 | ||
| The Setting | 74 | ||
| The Personnel | 75 | ||
| The Discussion | 75 | ||
| The Hardest of Talks: The Option of Pregnancy Termination | 77 | ||
| Prenatal Counseling: The Nurse’s and Social Worker’s Perspective | 78 | ||
| The Initial Visit | 78 | ||
| How Do Families Get to Us? | 78 | ||
| The Precounseling Huddle | 79 | ||
| Counseling | 79 | ||
| Benefits of Multidisciplinary Counseling | 80 | ||
| Debriefing | 80 | ||
| Patient Scenarios Illustrating the Value of Multidisciplinary Counseling | 80 | ||
| Scenario A: G1/P0, 28 Weeks’ Gestation, Dx: Tetralogy of Fallot, Normal Amniocentesis: 46XY | 80 | ||
| Scenario B: G3/P1, 24 Weeks’ Gestation, Dx: Hypoplastic Left Heart Syndrome, with Intact Atrial Septum, Declined Amniocentesis. Indication for Fetal Echo Was “Unable to Visualize Fetal Heart Adequately, Please Rule Out CHD” | 81 | ||
| Conclusions | 82 | ||
| Suggested Readings | 82 | ||
| II Congenital Heart Anomalies: Septal Defects | 83 | ||
| 7 Ventricular Septal Defects | 83 | ||
| Anatomy and Anatomical Associations | 84 | ||
| Frequency, Genetics, and Development | 84 | ||
| Prenatal Physiology | 86 | ||
| Prenatal Management | 86 | ||
| Postnatal Physiology | 86 | ||
| Postnatal Management | 87 | ||
| Outcomes | 87 | ||
| References | 88 | ||
| Cases | 89 | ||
| 8 Atrial Septal Defects | 97 | ||
| Anatomy and Anatomical Associations | 98 | ||
| Frequency, Genetics, and Development | 98 | ||
| Fetal Physiology | 99 | ||
| Prenatal Management | 99 | ||
| Postnatal Physiology | 99 | ||
| Postnatal Management | 99 | ||
| Outcomes | 99 | ||
| References | 100 | ||
| Case | 101 | ||
| 9 Atrioventricular Canal Defects | 103 | ||
| Anatomy and Anatomical Associations | 104 | ||
| Frequency, Genetics, and Development | 105 | ||
| Fetal Physiology | 106 | ||
| Prenatal Management | 106 | ||
| Postnatal Physiology | 107 | ||
| Postnatal Management | 108 | ||
| Outcomes | 108 | ||
| References | 109 | ||
| Cases | 111 | ||
| III Congenital Heart Anomalies: Conotruncal Defects | 117 | ||
| 10 Tetralogy of Fallot | 117 | ||
| Anatomy and Anatomical Associations | 118 | ||
| Frequency, Genetics, and Development | 119 | ||
| Fetal Physiology | 119 | ||
| Prenatal Management | 119 | ||
| Postnatal Physiology | 120 | ||
| Postnatal Management | 120 | ||
| Outcomes | 121 | ||
| References | 122 | ||
| Cases | 123 | ||
| 11 Tetralogy of Fallot with Pulmonary Atresia | 127 | ||
| Anatomy and Anatomical Associations | 128 | ||
| Frequency, Genetics, and Development | 129 | ||
| Prenatal Physiology | 129 | ||
| Prenatal Management | 129 | ||
| Postnatal Physiology | 129 | ||
| Postnatal Management | 130 | ||
| Outcomes | 131 | ||
| References | 131 | ||
| Cases | 133 | ||
| 12 Tetralogy of Fallot with Absent Pulmonary Valve Syndrome | 135 | ||
| Anatomy and Anatomical Associations | 136 | ||
| Frequency, Genetics, and Development | 137 | ||
| Fetal Physiology | 137 | ||
| Prenatal Management | 137 | ||
| Postnatal Physiology | 137 | ||
| Postnatal Management | 138 | ||
| Outcomes | 138 | ||
| References | 139 | ||
| Cases | 140 | ||
| 13 Malalignment of Conal Septum with Arch Obstruction | 143 | ||
| Anatomy and Anatomical Associations | 144 | ||
| Frequency, Genetics, and Development | 145 | ||
| Fetal Physiology | 145 | ||
| Prenatal Management | 146 | ||
| Postnatal Physiology | 147 | ||
| Postnatal Management | 147 | ||
| Outcomes | 147 | ||
| References | 148 | ||
| Cases | 149 | ||
| 14 Transposition of the Great Arteries | 153 | ||
| Anatomy and Anatomical Associations | 154 | ||
| Frequency, Genetics, and Development | 154 | ||
| Prenatal Physiology | 154 | ||
| Prenatal Management | 155 | ||
| Postnatal Physiology | 156 | ||
| Postnatal Management | 156 | ||
| Outcomes | 157 | ||
| References | 158 | ||
| Cases | 160 | ||
| 15 Corrected Transposition of the Great Arteries | 165 | ||
| Anatomy and Anatomical Associations | 166 | ||
| Frequency, Genetics, and Development | 167 | ||
| Fetal Physiology | 167 | ||
| Prenatal Management | 167 | ||
| Postnatal Physiology | 168 | ||
| Postnatal Management | 169 | ||
| Outcomes | 169 | ||
| References | 170 | ||
| Cases | 171 | ||
| 16 Double-Outlet Right Ventricle | 175 | ||
| Anatomy and Anatomical Associations | 176 | ||
| Frequency, Genetics, and Development | 177 | ||
| Prenatal Physiology | 177 | ||
| Prenatal Management | 177 | ||
| Postnatal Physiology | 178 | ||
| Postnatal Management | 178 | ||
| Outcomes | 179 | ||
| References | 179 | ||
| Cases | 181 | ||
| 17 Truncus Arteriosus | 185 | ||
| Anatomy and Anatomical Associations | 186 | ||
| Frequency, Genetics, and Development | 187 | ||
| Prenatal Physiology | 187 | ||
| Prenatal Management | 187 | ||
| Postnatal Physiology | 188 | ||
| Postnatal Management | 188 | ||
| Outcomes | 189 | ||
| References | 189 | ||
| Cases | 191 | ||
| 18 Aortopulmonary Window | 197 | ||
| Anatomy and Anatomical Associations | 198 | ||
| Frequency, Genetics, and Development | 198 | ||
| Prenatal Physiology | 199 | ||
| Prenatal Management | 199 | ||
| Postnatal Physiology | 199 | ||
| Postnatal Management | 199 | ||
| Outcomes | 199 | ||
| References | 200 | ||
| Cases | 201 | ||
| IV Congenital Heart Anomalies: Left-sided Heart Defects | 205 | ||
| 19 Aortic Stenosis | 205 | ||
| Anatomy and Anatomical Associations | 206 | ||
| Frequency, Genetics, and Development | 207 | ||
| Prenatal Physiology | 207 | ||
| Prenatal Management | 207 | ||
| Postnatal Physiology | 208 | ||
| Postnatal Management | 208 | ||
| Outcomes | 208 | ||
| References | 209 | ||
| Cases | 211 | ||
| 20 Coarctation of the Aorta | 217 | ||
| Anatomy and Anatomical Associations | 218 | ||
| Frequency, Genetics, and Development | 218 | ||
| Prenatal Physiology | 218 | ||
| Prenatal Management | 219 | ||
| Postnatal Physiology | 220 | ||
| Postnatal Management | 220 | ||
| Outcomes | 221 | ||
| References | 222 | ||
| Cases | 223 | ||
| 21 Congenital Absence of Aortic Valve Leaflets | 227 | ||
| Anatomy and Anatomical Associations | 228 | ||
| Frequency, Genetics, and Development | 228 | ||
| Prenatal Physiology | 228 | ||
| Prenatal Management | 228 | ||
| Postnatal Physiology | 229 | ||
| Postnatal Management | 229 | ||
| Outcomes | 229 | ||
| References | 229 | ||
| Case | 230 | ||
| 22 Hypoplastic Left Heart Syndrome | 231 | ||
| Anatomy and Anatomical Associations | 232 | ||
| Frequency, Genetics, and Development | 233 | ||
| Prenatal Physiology and Management | 233 | ||
| The Atrial Septum and Pulmonary Vasculature | 233 | ||
| Patterns of Aortic Blood Flow | 236 | ||
| The Right Ventricle and Cardiac Output | 236 | ||
| Prenatal Diagnostic Determination of Left Ventricle Inadequacy: Will the Left Ventricle Be Viable after Birth? | 237 | ||
| Prenatal Intervention: Can We Prevent the Evolution of Hypoplastic Left Heart Syndrome? | 238 | ||
| Postnatal Course and Management | 238 | ||
| Outcomes | 239 | ||
| References | 240 | ||
| Cases | 242 | ||
| 23 Aortic Stenosis and Mitral Valve Dysplasia Syndrome | 253 | ||
| Anatomy and Anatomical Associations | 254 | ||
| Frequency, Genetics, and Development | 254 | ||
| Prenatal Physiology | 255 | ||
| Prenatal Management | 256 | ||
| Postnatal Physiology | 256 | ||
| Postnatal Management | 258 | ||
| Outcomes | 258 | ||
| References | 259 | ||
| Cases | 260 | ||
| V Congenital Heart Anomalies: Right-sided Heart Defects | 265 | ||
| 24 Pulmonary Stenosis | 265 | ||
| Anatomy and Anatomical Associations | 266 | ||
| Frequency, Genetics, and Development | 267 | ||
| Prenatal Physiology | 267 | ||
| Prenatal Management | 267 | ||
| Postnatal Physiology | 268 | ||
| Postnatal Management | 268 | ||
| Long-term Outcomes | 268 | ||
| References | 269 | ||
| Cases | 271 | ||
| 25 Pulmonary Atresia with Intact Ventricular Septum | 275 | ||
| Anatomy and Anatomical Associations | 276 | ||
| Frequency, Genetics, and Development | 277 | ||
| Prenatal Physiology | 277 | ||
| Prenatal Management | 277 | ||
| Postnatal Physiology | 278 | ||
| Postnatal Management | 278 | ||
| Outcomes | 279 | ||
| References | 280 | ||
| Cases | 281 | ||
| 26 Ebstein’s Anomaly and Other Abnormalities of the Tricuspid Valve | 287 | ||
| Anatomy and Anatomical Associations | 288 | ||
| Frequency, Genetics, and Development | 289 | ||
| Prenatal Physiology | 289 | ||
| Prenatal Management | 289 | ||
| Postnatal Physiology | 290 | ||
| Postnatal Management | 290 | ||
| Outcomes | 290 | ||
| References | 291 | ||
| Cases | 292 | ||
| 27 Tricuspid Atresia | 297 | ||
| Anatomy and Anatomical Associations | 298 | ||
| Frequency, Genetics, and Development | 299 | ||
| Prenatal Physiology | 299 | ||
| Prenatal Management | 299 | ||
| Postnatal Physiology | 300 | ||
| Postnatal Management | 300 | ||
| Outcomes | 301 | ||
| Management of the Single Ventricle | 301 | ||
| References | 303 | ||
| Cases | 304 | ||
| VI Congenital Heart Anomalies: Single Ventricle | 307 | ||
| 28 Heterotaxy Syndrome and Complex Single Ventricle | 307 | ||
| Anatomy and Anatomical Associations | 308 | ||
| Frequency, Genetics, and Development | 309 | ||
| Prenatal Physiology | 310 | ||
| Prenatal Management | 311 | ||
| Postnatal Physiology | 311 | ||
| Postnatal Management | 312 | ||
| Outcomes | 313 | ||
| References | 315 | ||
| Cases | 317 | ||
| 29 Double-Inlet Left Ventricle | 325 | ||
| Anatomy and Anatomical Associations | 326 | ||
| Frequency, Genetics, and Development | 327 | ||
| Prenatal Physiology | 328 | ||
| Prenatal Management | 328 | ||
| Postnatal Physiology | 328 | ||
| Postnatal Management | 329 | ||
| Outcomes | 329 | ||
| References | 330 | ||
| Cases | 331 | ||
| VII Primary Anomalies and Disorders Affecting the Cardiovascular System in the Fetus | 337 | ||
| 30 Cardiac Masses and Tumors | 337 | ||
| Rhabdomyoma | 338 | ||
| Anatomy and Anatomical Associations | 338 | ||
| Frequency, Genetics, and Development | 339 | ||
| Prenatal Physiology | 339 | ||
| Prenatal Management | 339 | ||
| Postnatal Physiology | 339 | ||
| Postnatal Management | 340 | ||
| Outcomes | 340 | ||
| Teratoma | 340 | ||
| Anatomy and Anatomical Associations | 340 | ||
| Frequency, Genetics, and Development | 340 | ||
| Prenatal Physiology | 340 | ||
| VIII Disorders and Anomalies Secondarily Affecting the Cardiovascular System in the Fetus | 405 | ||
| 38 Twin-Twin Transfusion Syndrome | 405 | ||
| Anatomy and Anatomical Associations | 406 | ||
| Frequency, Genetics, and Development | 406 | ||
| Prenatal Physiology | 406 | ||
| Prenatal Management | 407 | ||
| Postnatal Physiology and Management | 411 | ||
| Outcomes | 412 | ||
| References | 413 | ||
| Cases | 415 | ||
| 39 Twin Reverse Arterial Perfusion | 423 | ||
| Anatomy and Anatomical Associations | 424 | ||
| Frequency, Genetics, and Development | 424 | ||
| Prenatal Physiology | 425 | ||
| Prenatal Management | 425 | ||
| Postnatal Physiology | 425 | ||
| Postnatal Management | 425 | ||
| Outcomes | 425 | ||
| References | 426 | ||
| Cases | 428 | ||
| 40 Sacrococcygeal Teratoma | 431 | ||
| Anatomy, Frequency, and Development | 432 | ||
| Prenatal Physiology and Diagnosis | 432 | ||
| Prenatal Management | 433 | ||
| Postnatal Physiology, Management, and Outcome | 434 | ||
| References | 436 | ||
| Cases | 438 | ||
| 41 Cerebral Arteriovenous Malformation | 443 | ||
| Anatomy and Anatomical Associations | 444 | ||
| Frequency, Genetics, and Development | 444 | ||
| Prenatal Physiology | 444 | ||
| Prenatal Management | 444 | ||
| Postnatal Physiology, Management, and Outcomes | 445 | ||
| References | 445 | ||
| Cases | 447 | ||
| 42 Pulmonary Arteriovenous Malformation | 451 | ||
| Anatomy and Anatomical Associations | 452 | ||
| Frequency, Genetics, and Development | 452 | ||
| Prenatal Physiology | 452 | ||
| Prenatal Management | 453 | ||
| Postnatal Physiology and Management | 453 | ||
| Outcomes | 453 | ||
| References | 454 | ||
| Case | 455 | ||
| 43 Congenital Cystic Adenomatoid Malformation | 457 | ||
| Anatomy and Anatomical Associations | 458 | ||
| Frequency, Genetics, and Development | 458 | ||
| Prenatal Physiology | 459 | ||
| Prenatal Management and Outcomes | 460 | ||
| Postnatal Physiology and Management and Outcomes | 462 | ||
| References | 462 | ||
| Cases | 463 | ||
| 44 Congenital Diaphragmatic Hernia | 465 | ||
| Anatomy and Anatomical Associations | 466 | ||
| Frequency, Genetics, and Development | 466 | ||
| Prenatal Physiology | 467 | ||
| Prenatal Management | 467 | ||
| Postnatal Physiology and Management | 468 | ||
| Outcomes | 469 | ||
| References | 469 | ||
| Cases | 471 | ||
| IX Abnormalities of the Conduction System | 477 | ||
| 45 Arrhythmias in the Fetus | 477 | ||
| Introduction | 478 | ||
| Premature Atrial and Premature Ventricular Contractions | 478 | ||
| Fetal Tachyarrhythmias | 480 | ||
| Supraventricular Tachycardia | 480 | ||
| Atrial Flutter | 482 | ||
| Management of Fetal Atrial Tachyarrhythmias | 482 | ||
| Ventricular Tachycardia | 485 | ||
| Sinus Bradycardia | 486 | ||
| Congenital Complete Heart Block | 486 | ||
| Summary | 489 | ||
| References | 490 | ||
| X New Frontiers in Fetal Cardiovascular Imaging | 493 | ||
| 46 Anatomical and Functional Fetal Cardiac Magnetic Resonance Imaging: | 493 | ||
| Why Apply Cardiac Magnetic Resonance Imaging to the Fetus: Is there a Need for Another Imaging Modality? | 494 | ||
| The Development of Fetal Cardiac MRI for Visualizing Cardiovascular Morphology and Myocardial Motion | 495 | ||
| Safety of Fetal MRI | 495 | ||
| The Emerging Discipline of Fetal Cardiac MRI | 498 | ||
| The Future | 499 | ||
| References | 499 | ||
| Index | 501 | ||
| A | 501 | ||
| B | 502 | ||
| C | 502 | ||
| D | 503 | ||
| E | 504 | ||
| F | 505 | ||
| G | 505 | ||
| H | 505 | ||
| I | 506 | ||
| J | 506 | ||
| K | 506 | ||
| L | 506 | ||
| M | 506 | ||
| N | 507 | ||
| O | 507 | ||
| P | 507 | ||
| R | 508 | ||
| S | 508 | ||
| T | 508 | ||
| U | 510 | ||
| V | 510 | ||
| W | 511 | ||
| Z | 511 |