PMC6207888_01
Fetal pericardial effusions. Fetal Twin A (a) and fetal Twin B (b) showing similar small apical pericardial effusions (*).
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fig1
Fetal echocardiography was performed initially at 27 weeks and 2 days gestation, showing each twin had a complete, balanced AVSD of Rastelli type A consisting of a moderate-sided inlet VSD, a small primum ASD, a probable small secundum ASD, and a single atrioventricular valve with trivial left-sided and mild central atrioventricular valve regurgitation and a small predominantly apical pericardial effusion (Figures 1 and 2(a)-2(d)).
Fetal four-chamber cardiac images. (a) Twin A 2D imaging showing a ventricular septal defect, primum atrial septal defect, and secundum atrial septal defect. (b) Twin A color Doppler showing left and central atrioventricular valve regurgitation (red flashes moving toward the transducer). (c) Twin B 2D imaging showing a ventricular septal defect, primum atrial septal defect, and secundum atrial septal defect (drop out artifact between these defects gives the incorrect appearance of a large single defect). (d) Twin B color Doppler showing left and central atrioventricular valve regurgitation (blue flashes moving away from the transducer).
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fig2
Fetal echocardiography was performed initially at 27 weeks and 2 days gestation, showing each twin had a complete, balanced AVSD of Rastelli type A consisting of a moderate-sided inlet VSD, a small primum ASD, a probable small secundum ASD, and a single atrioventricular valve with trivial left-sided and mild central atrioventricular valve regurgitation and a small predominantly apical pericardial effusion (Figures 1 and 2(a)-2(d)).
Postnatal four-chamber cardiac images. (a) Twin A 2D imaging showing a ventricular septal defect, primum atrial septal defect, and secundum atrial septal defect. (b) Twin A color Doppler showing left, central, and right atrioventricular valve regurgitation (blue flashes moving away from the transducer. (c) Twin B 2D imaging showing a ventricular septal defect, primum atrial septal defect, and secundum atrial septal defect. (d) Twin B color Doppler showing left and right atrioventricular valve regurgitation (blue flashes moving away from the transducer).
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fig3
Transthoracic echocardiography on day of life one confirmed the diagnosis of Rastelli type A complete AVSD with moderate atrial and ventricular septal defects, a balanced common atrioventricular valve with mild right and trace left atrioventricular valve regurgitation, and a patent foramen ovale (Figures 3(a) and 3(b)). Transthoracic echocardiogram on day of life one confirmed the diagnosis of Rastelli type A complete AVSD with a large atrial septal defect and a moderate ventricular septal defect, a balanced common atrioventricular valve with mild right and trace left atrioventricular valve regurgitation, and a patent foramen ovale (Figures 3(c) and 3(d)).