Fetal Echocardiographic Features for the Prediction of the Development of Aortic Coarctation in the Perinatal Period

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PURPOSE: Aortic coarctation (CoA) is a congenital structural anomaly with one of the lowest detection rates among heart diseases. Improving diagnostic rates allows for the centralization of high-risk cases in hospitals with pediatric cardiac surgery facilities, thereby reducing neonatal mortality and morbidity. This study aims to evaluate new diagnostic protocols to enhance the clinical and outpatient management of suspected CoA cases. METHODS: A retrospective analysis was conducted, focusing on various echocardiographic parameters to identify the most predictive indicators for CoA. RESULTS: A total of 184 cases with a prevalence of right-sided heart sections were identified, with 128 patients meeting the inclusion criteria. Of these, 15 cases of CoA were confirmed postnatally, representing 11.7% of the cohort. Among these, 80% showed early echocardiographic signs of CoA. The ratio of pulmonary valve (PV) to aortic valve (AV) diameters emerged as the most reliable parameter, especially in early gestation, while the z-score of the aortic isthmus was also a strong predictor. CONCLUSION: The use of simple, reliable echocardiographic parameters can improve the detection rate of high-risk CoA cases, enabling better clinical management and improved neonatal outcomes in both the short and long term.

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