Institution: | 1. Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands;2. Department of Obstetrics and Fetal Medicine, LUMC, Leiden University, Leiden, The Netherlands;3. Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
Amsterdam Reproduction and Development, Amsterdam, The Netherlands;4. Amsterdam Reproduction and Development, Amsterdam, The Netherlands
Department of Obstetrics and Gynecology, Amsterdam UMC Location Vrije Universiteit, Amsterdam, The Netherlands;5. Department of Pediatric Cardiology, LUMC, Leiden University, Leiden, The Netherlands;6. Department of Pediatric Cardiology, Amsterdam UMC Location Vrije Universiteit, Amsterdam, The Netherlands;7. Department of Radiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands;8. Department of Otorhinolaryngology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands;9. Department of Cardiothoracic Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands;10. Amsterdam Reproduction and Development, Amsterdam, The Netherlands
Department of Pediatric Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands |
Abstract: | Objectives To determine the proportion of children that require surgery in the first year of life and thereafter in order to improve the counseling of parents with a fetus with a right aortic arch (RAA). Methods Fetuses diagnosed with isolated RAA, defined as the absence of intra- or extracardiac anomalies, between 2007 and 2021 were extracted from the prospective registry PRECOR. Results In total, 110 fetuses were included, 92 with a prenatal diagnosis of RAA and 18 with double aortic arch (DAA). The prevalence of 22q11 deletion syndrome was 5.5%. Six pregnancies were terminated and five cases were false-positive; therefore, the follow-up consisted of 99 neonates. Surgery was performed in 10 infants (10%) in the first year of life. In total, 25 (25%) children had surgery at a mean age of 17 months. Eight of these 25 (32%) had a DAA. Only one child, with a DAA, required surgery in the first week of life due to obstructive stridor. Conclusions Children with a prenatally diagnosed RAA are at a low risk of acute respiratory postnatal problems. Delivery in a hospital with neonatal intensive care and pediatric cardiothoracic facilities seems only indicated in cases with suspected DAA. Expectant parents should be informed that presently 25% of the children need elective surgery and only incidentally due to acute respiratory distress. |