文／台兒診所 陳芮瑜放射師
初診日期：2019年3月
產前診斷：台兒診所 周昱青醫師、陳彥妮醫師、池宛玲醫師、黃怡伶醫師、蘇婉婷放射師、陳芮瑜放射師、温姿敏放射師、黃思萍放射師、雙和醫院 張君堯醫師、台大醫院 施景中醫師
產後診斷、追蹤：台大醫院 陳俊安醫師
診斷：Congenitally corrected transposition of the great arteries (ccTGA) with ventricular septal defect (VSD)
(1) Indication: Suspect situs ambiguous
(2) History: - G2P1 - Karyotyped and aCGH done after 21 weeks
(2) Image findings:
- 21wks:
Situs solitus.
Mesocarida.
Atrio-ventricular discordance. (image 1)
Ventriculo-arterial discordance. (image 2)
No VSD.
Diagnosis: Congenitally corrected transposition of the great arteries (ccTGA).
- 25wks: Congenitally corrected transposition of the great arteries with VSD. (image 3) No pulmonary stenosis.
- 35wks: Congenitally corrected transposition of the great arteries with VSD.
No pulmonary stenosis. (image 4)
No significant TR.
Fetal heart rate: 132bpm.
Image1: 21wk: Mesocardia. Atrioventricular discordant. Left atrium on the left side and connects to morphological right ventricle. Right atrium on the right side and connects to morphological left ventricle.
Image 2 : 21wk: Ventriculo-arterial discordant. Morphological right ventricle connects to aorta. Morphological left ventricle connects to pulmonary artery.
Image 3 : 25wk: VSD noted.
Image 4 : 35wk: No pulmonary stenosis.
Outcome:
- NSD at GA 39+1 weeks, BBW:3022gm, Apgar score: 8→ 9. Well activity and respiratory condition.
- Echocardiography on the first day of life: ccTGA with perimembranous inlet type VSD. PDA. PFO.
- Stable clinical condition. Discharged 3 days after birth.
- OPD follow up: No heart failure symptoms/signs in infancy. Fair growth and development.
