EP09.33: Utility of novel echocardiographic measurements to improve prenatal diagnosis of coarctation of the aorta

Prenatal recognition of coarctation of the aorta (CoA) may improve neonatal survival and reduce morbidity. However, prenatal diagnosis of CoA remains challenging, with relatively high false-positive and false-negative rates. This study aimed to identify a novel formula based on fetal echocardiographic measures to predict prenatal identification of CoA. A retrospective comparison on the echocardiographic evaluation of 30 patients with suspected CoA between May 2016 and April 2021 was performed. The patients were divided into a postnatal surgical intervention group (n = 13) and a non-intervention group (n = 17). Fetal cardiac dimension measurements were compared between the two groups. General heart measurements included cardiothoracic area ratio and total cardiac dimension. The measurement parameters were Z-values of the left and right ventricle, Z-values of the great arteries, the ratio of those measurement values, and ductus arteriosus to aortic isthmus diameter (D/I), and the distal aortic arch (DA) index, which was calculated as the ratio of the distance between the left carotid artery and the left subclavian artery, in the prenatal period have been calculated. The measurements that showed significant differences were aortic isthmus diameter Z-score (p < 0.001), ductus arteriosus diameter/aortic isthmus diameter (p < 0.001), and distal aortic arch (DA) index (p < 0.001). and the other parameter did not show significant differences between the groups. In the receiver operating characteristic curves analysis, the DA index was the largest with an area under the curve of 0.941 and a cutoff value of 1.28, with a sensitivity of 85% and a specificity of 94%. Measurement of the DA index improved the diagnostic rate of fetal CoA and a DA index ≧ 1.28 indicated fetal CoA cases requiring surgical intervention.