Diagnóstico antenatal de

Cardiopatías Congénitas
Dr. A. Sosa Olavarría
Circulación Fetal

Ductus Venoso
Impacto del Diagnóstico Precoz
en las Cardiopatias Congénitas
Dr. Pablo Marantz, Dra. Marianna Guerchicoff
Cardiología Infantil, Departamento de Pediatría,
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
 Cardiopatías Congénitas: Recursos
Diagnósticos

 Embarazo Temprano: Translucencia

nucal, OVF ductus venoso y USTV.
 Embarazo Avanzado: USBDT, modo TM,
Doppler pulsado y a Color
Ectopia Cordis

Sosa@2000
Izq. Der.

C Sosa Olavarría
SITUS SOLITUS

Der. Izq.

C Sosa Olavarría
 SITUS INVERSUS

Der.
Izq.

C Sosa Olavarría
 ISOMERISMO

C Sosa Olavarría
ISOMERISMO

Der. Izq.

C Sosa Olavarría
AP dilatada
C Sosa Olavarría
C Sheley el al. 1995
C Sosa Olavarría
C Sosa Olavarría
Aneurisma de la Fosa Oval
Movimiento bifásico
normal

Movimiento de la aneurisma
Tetralogía de Fallot
Tetralogía de Fallot
Fallot

Normal
Anomalía de Ebstein
Anomalía de Ebstein
Anomalía de Ebstein
Anomalía de Ebstein
AP

AD
AD

Ao VD
Interrupción del Arco Aórtico
OVF de Art. Pulmonar
 Fig. 7: Van Praagh classification12. Truncus arteriosus is classified into two
types, based on the presence (type A) or absence (type B) of a ventricular
septal defect. The 2 types are further subclassified into 4 subtypes,
depending on the orientation of the great arteries.  In subtype 1 (Left), the
aorticopulmonary septum is incompletely formed, resulting in a partially
separate main pulmonary artery. In subtype 2 (Middle left), the
aorticopulmonary septum is entirely absent with both pulmonary arteries
arising directly from the truncus. In subtype 3 (Middle right), one pulmonary
artery is absent and that lung is supplied by collateral arteries from the
descending aorta. In subtype 4 (Right), hypoplasia, coarctation, atresia, or
absence of the aortic arch is associated with a large patent ductus arteriosus.
 
Fig. 8: Collett and Edwards classification13: type 1 (Left): a single pulmonary
trunk and ascending aorta arise from the truncus arteriosus; type 2 (Middle
left): both pulmonary arteries originate close together from the dorsal wall of
the truncus arteriosus; type 3 (Middle right): one or both pulmonary arteries
arise independently from the side of the truncus arteriosus; and type 4
(Right): absence of the pulmonary arteries with the pulmonary circulation
being supplied from collateral arteries arising from the descending aorta.
Agenesia de válvula pulmonar
Estenosis Pulmonar
VDDS
Hipoplasia de VD
Cierre del Ductus Arterioso
Exposición al nimensulide
Tumores Cardíacos
Aparato Valvular accesorio
Fibroma Cardíaco
Pericardial teratoma
Ductal agenesis with infrahepatic connection to
the IVC
Trastornos del Ritmo Cardíaco

 Arritmia sinusoidal
 Taquicardia supraventricular
 Taquicardia ventricular
 Bradicardia sinusal
 Bloqueo AV
Despolarización normal
Fibrilación Atrial
Bradicardia
Bloqueo A-V
 AI
CC Ductus dependiente

VD
 Cardiac anomaly n
Atrioventricular septal defect 5
Isolated ventricular septal defect 16
Ventricular septal defect + extracardiac anomaly 1
Tetralogy of Fallot 2
Pulmonary atresia + ventricular septal defect 2

Double outlet right ventricle 4

Aortic stenosis 2
Hypoplastic left heart ventricle 6
Coarctation of the aorta 2
Single ventricle 1
Ebstein anomaly 1
Transposition of the great arteries (d) 1

F. Viñals*, J. Tapia* and A. Giuliano*Prenatal detection of ductal-

dependent congenital heart disease: how can things be made
easier? Ultrasound in Obstetrics & Gynecology
19 3 246 - March 2002
Drenaje venoso
pulmonar anómalo