PMC3327023_01
Fetal echocardiography at 35 weeks of gestation showed a giant tumor involving mitral valve which extended from the left atrium to the left ventricle (a). Color Doppler ultrasound showed severely reduced left ventricular inflow flow (b) and antegrade aortic flow
APC-5-78-g001.jpg
PMC3327023_01_APC-5-78-g001.jpg
F1
Frequent SVT episodes had been documented since 35 weeks of gestation [Figure 1].
Echocardiography shows a large tumor widely extended from the left atrium (LA) through mitral valve to the left ventricle (LV) in the short (a), parasternal (b), and four-chamber (c) views. Doppler ultrasound showed reversed ductus flow from pulmonary artery to aorta which dominant to ductus flow from aorta to pulmonary artery (d). RA: Right atrium, RV: Right ventricle, LA: Left atrium, LV: Left ventricle, PA: Pulmonary artery
APC-5-78-g002.jpg
PMC3327023_01_APC-5-78-g002.jpg
F2
The tumor widely extended from the left atrium (LA) through mitral valve to the left ventricle (LV) on an echocardiogram [Figure 2]in the short [Figure 2a], parasternal [Figure 2b], and four-chamber [Figure 2c] views. Systemic circulation depended on the retrograde ductus arteriosus blood flow [Figure 2d], because the tumor occupied the majority of left ventricular cavity and severely reduced antegrade aortic flow.
Electrocardiogram of the sinus rhythm showed pre-excitation (a) and supraventricular tachycardia (b)
APC-5-78-g003.jpg
PMC3327023_01_APC-5-78-g003.jpg
F3
The SVT [Figure 3b] could be stopped by adenosine injection and the SVT suggested orthodromic atrioventricular tachycardia. The patient underwent bilateral pulmonary artery banding (each banding size: 12 mm) to maintain the systemic circulation at 16 days after birth.
PMC3327023_02