Fetal Cardiac and Pericardial Tumors

Abstracts The fetal diagnosis of TAPVC is more important in perinatal managements not only for avoiding emergency surgery but also for lifesaving, if we could improve our detection rate. T10-15-IN07 Ventricular Septal Defects-Why Are They Missed? Greggory R. DeVore, MD Department of Obstetrics and Gynecology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA Imaging of the 4-chamber view is not adequat4 for detecting ventricular septal defects. The technique described in this presentation will illustrate movement of the transducer beam that sweeps the heart in longitudinal and transverse planes and using color/power Doppler ultrasound. T10-15-IN08 How to Assess Fetal Rhythm? Satoshi Yasukochi Heart center, Nagano Children’s Hospital, Nagano, Japan The currently available modalities to assess fetal rhythm are (1) fetal echocardiographic evaluation using either M-mode or Pulse Doppler, or strain, (2) fetal magnetogram, (3) fetal electrocardiogram. In general, fetal echocardiographic evaluation for fetal rhythm is popular. Before using fetal echocardiography as a tool for rhythm assessment, there must be the assumption that an electrical conduction mode is the same as those of mechanical contraction. On the basis of this assumption, M-mode assessment for fetal rhythm is from images lining the atrium to ventricle which enables to measure the timing of atrial and ventricular contraction. The pulse Doppler measurement for fetal rhythm is more accurate but needs more experience because of its requirement to set image plane and sample point and sample point on SVC-AO. The assessment of fetal rhythm by fetal echocardiogram is now popular and set on guide lines from fetal echocardiography. We will present how to use fetal echocardiography as a tool to detect fetal rhythm. T10-15-IN09 Fetal Cardiac and Pericardial Tumors Tuangsit Wataganara Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, BKK, Thailand Isolated fetal pericardial effusions are frequently detected on routine obstetric scans. The exact incidence and significance of this finding is not clearly understood. The perinatal outcome in such cases depends on the presence or otherwise of associated malformations and chromosomal aberrations. Management of a fetus with pericardial effusion involves a multidisciplinary review of the problem to consider the competing fetal and maternal implications. Close monitoring of the fetal biophysical profile along with serial echocardiographic assessments and pericardiocentesis may allow the delivery to be delayed until adequate lung maturity is achieved. Current evidence indicates good outcome in cases of isolated pericardial effusion. Large prospective studies are needed to resolve the issue of association with chromosomal aberration that has significant impact on antenatal management and counseling policies in such cases. T10-15-IN10 Outcome After Newborn of Prenatally Diagnosed Congenital Heart Block with Postnatal Pacemaker Implantation An-Shine Chao Chang-Gung Memorial Hospital, Taiwan

S121 Introduction of Congenital atrioventricular block Prenatal diagnosis Prenatal intervention Postnatal intervention Long-term survival

T10-15-IN11 Fetal Arrhythmias: Diagnosis and Management Made Easy Mark Sklansky, MD Pediatric Cardiology, UCLA Mattel Children’s Hospital, David Geffen School of Medicine at UCLA Fetal arrhythmias may be diagnosed using a variety of approaches, including m-mode, color-mode, 2D, 2D with color, and spectral Doppler. Arrhythmias may be classified as ectopy, bradycardia or tachycardia. Detailed evaluation will facilitate making the correct diagnosis which, in turn, will allow for appropriate counseling and management, leading to optimal outcomes. Whether to treat a fetal arrhythmia pharmacologically must consider a multiple of sometimes competing fetal and maternal considerations. This talk will describe the various modalities available for the evaluation and diagnosis of arrhythmias, and will then describe the management and prognosis associated with ectopy, bradyarrhythmias and tachyarrhythmias. T10-15-IN12 DORV–Double Outlet Right Ventricle Dr. T. L. N. Praveen Department of Fetal Medicine, Abhishek’s Institute of Imageology, Hyderabad, Telangana, India Double outlet right ventricle is a cono-truncal abnormality in which the great arteries arise either predominantly or entirely from the right ventricle. DORV is categorized based on the spatial relationship of great arteries, location of VSD and presence or absence of outflo Care Ultrasonography (POw obstruction. Great arteries relationship and location of VSD are of four types. 4 chamber view is usually normal, 5 chamber view reveals VSD and origin of great arteries. 3VT shows discrepancy of great arteries. D/D – TOF and CTGA. T10-15-IN13 Fetal Heterotaxy Syndrome Mark Sklansky, MD Pediatric Cardiology, UCLA Mattel Children’s Hospital, David Geffen School of Medicine at UCLA Heterotaxy refers to disordered laterality of abdominal viscera, thoracic organs, and cardiac segments. Though commonly categorized broadly into two subtypes, it probably makes more sense to consider heterotaxy as a spectrum. Complex forms of heterotaxy can be best evaluated using an ordered, segmental approach to evaluation of the heart. Particular attention should be paid to venous returns and great arterial arrangements, as both are commonly abnormal in the case of heterotaxy. Affected fetuses are at risk for single ventricle anatomy, obstruction of pulmonary venous return, heart block, and heart failure, as well as GI and occasionally CNS/GU/musculoskeletal pathology. This talk will review these concepts of heterotaxy and provide a detailed demonstration of the echocardiographic findings.