Tetralogy of Fallot with pulmonary atresia (fetal echocardiogram)

Case contributed by Cathy Cluver

Presentation

Tertiary assessment for fetal echocardiography.

Patient Data

Age: Second trimester scan
Gender: Female

3VT view demonstrates reverse filling of the duct, a key feature differentiating this subtype from the more common TOF with pulmonary stenosis.

Note that the duct is on the right side of the image, as the fetus is in breech position.

Case Discussion

There are a number of different subtypes of tetralogy of Fallot: Tetralogy of Fallot with pulmonary stenosis (75%), Tetralogy of Fallot with pulmonary atresia (20%) and Dysplastic (absent/ring) pumonary valve syndrome (5%).

This case demonstrates the typical findings on the standard fetal echo views in a case of tetralogy of Fallot with pulmonary atresia. The key features that differentiate this from the more common pulmonary stenosis subtype are the absence of the pulmonary trunk on the RVOT view and reverse flow in the ductus appreciated on the 3VT view.

Images courtesy of Dr Simon Meagher

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