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2014-03-21-18 Early coronary fistula: a benign phenomenon © Bronshtein www.TheFetus.net


Early coronary fistula: a benign phenomenon


Moshe Bronshtein, MD.

Haifa, Israel.

Case report

High velocity flows within the region of the coronary sinus may be sometimes observed during early examination of fetal heart (14-17 weeks). Following cases demonstrate a fistula between the right ventricle and coronary sinus that was observed at 15 weeks (case 1) and similar fistula combined with tricuspid regurgitation (case 2).

We had several similar findings in our practice - six of them presented as an abnormal high velocity flow at the level of the right ventriculo-atrial junction, two of them were seen at the level of the left ventriculo-atrial junction. In all cases the finding had disappeared within 1 to 7 days and all newborns had normal cardiac morphology.

We think that coronary sinus fistula in the early pregnancy represents a benign transient phenomenon.

Case 1

Images 1, 2, and videos 1, 2: 15 weeks of pregnancy; the images and video show a fistula between the right ventricle and right atrium (red flow marked by arrow on the image 2). 

 

 


Video 3: The video shows the heart of the same fetus as showed above. The video was done two days later and the fistula described above was not seen anymore. 

 


Case 2

Images 3, 4, and video 4: The images and videos show a fistula between the right ventricle and right atrium (blue flow marked by arrow on the image 2). Except for the fistula, tricuspid dysplasia and regurgitation was also observed (video 4).

 

 

References

Bronshtein M, Zimmer EZ, Blazer S, Blumenfeld Z. Transient abnormal fetal cardiac flow patterns at 13 to 17 gestational weeks. Prenat Diagn. 2012 May;32(5):444-9. doi: 10.1002/pd.3836. Epub 2012 Apr 12.


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