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Answer to the case of the week # 528

December 10th, 2020 - December 31st, 2020

Moshe Bronshtein, MD1

 1  Haifa, Rambam, Israel

First trimester screening test risk for Down syndrome was low.
We suspected a heart anomaly at 14WG+6days.
Our ultrasound examination revealed the following findings:

The following images explains the cardiac anomaly:
(MPA: Main Pulmonary Artery, A or AOR: Aorta; S: Interventricular Septum)
-membranous Ventricular Septal Defect 
-overriding aorta, normal size
-small sized main pulmonary artery, with reversed flow on color doppler
-there are probably pulmonary arteries arising from the descending aorta: MAPCA Major AortoPulmonary Collateral Arteries


Therefore our diagnosis was Pulmonary Atresia with VSD and MAPCAs
(This situation is also called "severe tetralogy of fallot" or "tetralogy of fallot with pulmonary atresia).

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