田中 守, 名取 道也, 河野 八朗, 石本 人士, 小林 俊文, 野澤 志朗

Mamoru TANAKA, Michiya NATORI, Hachiro KOHNO, Hitoshi ISHIMOTO, Toshifumi KOBAYASHI, Shiro NOZAWA

慶應義塾大学医学部産婦人科学教室

Department of Obstetrics and Gynecology, Keio University School of Medicine

キーワード : Prenatal diagnosis, Aortic stenosis, Mitral valve regurgitation, Color doppler echocardiography, Twin-twin transfusion syndrome

A fetus with aortic stenosis and mitral valve insufficiency diagnosed prenatally at 26 weeks of gestation is presented. An accurate diagnosis of this fetus was possible by application of color doppler echocardiography, which demonstrated forward flow through the stenotic aortic valve in the ascending aorta, pansystolic mitral valve regurgitation, and absent flow across the foramen ovale. This case also suffered from the twin-twin transfusion syndrome as a recipient. A new surgical approach of stabilization with cardiopulmonary bypass in critically ill infants, followed by relief of left ventricular outflow tract obstructions, has come to be available recently. Fetal echocardiography has yet to show an impact on the treatment of this congenital heart disease. Under accurate prenatal diagnosis of congenital heart disease, aggressive treatment of potentially salvageable fetuses with congenital heart disease could improve this outcome.