Three-dimensional fetal echocardiography for prediction of postnatal surgical approach in double outlet right ventricle: a pilot study

Objectives
To examine the feasibility of reconstructing three-dimensional (3D) echocardiographic views in fetuses with double outlet right ventricle, which might enhance prognostication with respect to the postnatal surgical approach.

Methods
This was a retrospective blinded observational study. Our database was reviewed from January 2007 to June 2011 to identify fetuses with usual atrial arrangement, concordant atrioventricular connections, double outlet right ventricle and relatively balanced left and right ventricular size. Six fetuses, in which there was an intention to treat, were included.

Results
In all six cases, we identified important features, including location of the ventricular septal defect and its relation to the atrioventricular valves and great arteries. The postnatal surgical approach was predicted accurately in each case.

Conclusion
In this group of fetuses with double outlet right ventricle, detailed evaluation by 3D fetal echocardiography enhanced visualization of the anatomy, leading to accurate prediction of the type of surgical repair. Prospective validation in a large cohort of fetuses is warranted.