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Prenatal echocardiographic diagnosis of cardiac right/left axis and malpositions according to standardized Cordes technique [Anatol J Cardiol]
Anatol J Cardiol. 2011; 11(2): 131-136 | DOI: 10.5152/akd.2011.033  

Prenatal echocardiographic diagnosis of cardiac right/left axis and malpositions according to standardized Cordes technique

Süheyla Özkutlu1, Özlem Mehtap Bostan2, Özgür Deren2, Lütfü Önderoğlu2, Gülsev Kale3, Şafak Güçer4, Diclehan Orhan1
1Department of Pediatric Cardiology Faculty of Medicine, Hacettepe University, Ankara, Turkey
2Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara
3Department of Pediatric Pathology, Faculty of Medicine, Hacettepe University, Ankara
4* Department of Pediatric Pathology, Faculty of Medicine, Hacettepe University, Ankara

Objective: The aim of this study was to evaluate distinguishing the right / left side of the fetus, cardiac axis and position according to the standardized Cordes technique in 20 cases with cardiac malposition. Methods: We studied retrospectively 1536 cases whose fetal echocardiographic examinations were performed between 1999 and 2006 in prenatal cardiology unit. Among these, cardiac malpositions were determined in 20 cases. The cardiac axis and position were determined according to the Cordes technique. All cases were followed-up by serial fetal echocardiograms until birth or intrauterine death occurred. In cases of intrauterine death, an autopsy was performed. After birth, physical and echocardiographic examinations were done and prenatal and postnatal diagnoses were compared. Results: Of 1536 fetal echocardiograms performed, 144 revealed congenital heart diseases (9.4%), among these cases 20 were diagnosed with cardiac malposition. Of cases with cardiac malposition, 16 had congenital heart disease, and four had extracardiac malformation. There were six cases of isolated dextrocardia, three cases of situs inversus totalis, six cases of situs ambiguous, and one case of situs inversus with isolated levocardia. Of four cases with extracardiac malformations, two cases had mesoposition, one had dextroposition, and one had extreme levoposition. In six cases the autopsy findings were the same as that their prenatal echocardiographic findings. When postnatal echocardiographic results of the remaining cases with cardiac malposition due to congenital heart disease were compared with prenatal diagnoses, the same echocardiographic findings were verified. Conclusion: The fetal right/left axis must be determined correctly for the accurate diagnosis of cardiac malpositions. Therefore, we recommend that Cordes technique provides a simple and reliable determination of the fetal right/left axis and fetal situs.

Keywords: Fetal echocardiography, fetal situs, fetal cardiac malposition, dextrocardia, situs ambiguous, Cordes technique


Süheyla Özkutlu, Özlem Mehtap Bostan, Özgür Deren, Lütfü Önderoğlu, Gülsev Kale, Şafak Güçer, Diclehan Orhan. Prenatal echocardiographic diagnosis of cardiac right/left axis and malpositions according to standardized Cordes technique. Anatol J Cardiol. 2011; 11(2): 131-136


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