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Gaeta G, Fesslova V, Villanacci R, Morano D, Candiani M, Pozzoni M, Papale M, Spinillo SL, Chiarello C, Cavoretto PI. Prenatal Diagnosis and Postnatal Outcomes of Left Brachiocephalic Vein Abnormalities: Systematic Review. J Clin Med 2022; 11:jcm11071805. [PMID: 35407413 PMCID: PMC9000070 DOI: 10.3390/jcm11071805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/09/2022] [Accepted: 03/22/2022] [Indexed: 02/01/2023] Open
Abstract
Abnormalities of the left brachiocephalic vein (LBCVA) are rare and poorly studied prenatally. An association with congenital heart defects (CHD), extracardiac and genetic abnormalities was described. The aim of our study was to estimate the rate and summarize the available evidence concerning prenatal diagnosis, associated anomalies, and outcomes of these anomalies. A systematic literature review was carried out selecting studies reporting on prenatal diagnosis of LBCVA, including unpublished cases from our experience. Frequencies were pooled from cohort studies to calculate prenatal incidence. Pooled proportions were obtained from all the studies including rates of associated CHD, extracardiac or genetic abnormalities and neonatal outcomes. The search resulted in the selection of 16 studies with 311 cases of LBCVA, with an incidence of 0.4% from six cohort studies. CHD occurred in 235/311 (75.6%) fetuses: 23 (7.4%) were major in cases of double, retroesophageal or subaortic course and 212 (68.2%) were minor in cases of absence (always associated with a persistent left superior vena cava) or intrathymic course. Data on other associated outcomes were scarce showing rare extracardiac anomalies (3.5%), rare genetic abnormalities (RASopathies and microdeletions associated with the retroesophageal course), and neonatal outcomes favorable in most cases, particularly in intrathymic forms.
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Affiliation(s)
- Gerarda Gaeta
- Gynecology and Obstetrics Department, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy; (G.G.); (R.V.); (M.C.); (M.P.); (M.P.); (S.L.S.); (P.I.C.)
- Gynecology and Obstetrics Department, University Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milan, Italy
| | - Vlasta Fesslova
- Center of Fetal Cardiology, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097 Milan, Italy;
- Correspondence:
| | - Roberta Villanacci
- Gynecology and Obstetrics Department, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy; (G.G.); (R.V.); (M.C.); (M.P.); (M.P.); (S.L.S.); (P.I.C.)
- Gynecology and Obstetrics Department, University Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milan, Italy
| | - Danila Morano
- Center of Fetal Cardiology, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097 Milan, Italy;
| | - Massimo Candiani
- Gynecology and Obstetrics Department, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy; (G.G.); (R.V.); (M.C.); (M.P.); (M.P.); (S.L.S.); (P.I.C.)
- Gynecology and Obstetrics Department, University Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milan, Italy
| | - Mirko Pozzoni
- Gynecology and Obstetrics Department, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy; (G.G.); (R.V.); (M.C.); (M.P.); (M.P.); (S.L.S.); (P.I.C.)
- Gynecology and Obstetrics Department, University Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milan, Italy
| | - Margherita Papale
- Gynecology and Obstetrics Department, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy; (G.G.); (R.V.); (M.C.); (M.P.); (M.P.); (S.L.S.); (P.I.C.)
- Gynecology and Obstetrics Department, University Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milan, Italy
| | - Silvia Lina Spinillo
- Gynecology and Obstetrics Department, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy; (G.G.); (R.V.); (M.C.); (M.P.); (M.P.); (S.L.S.); (P.I.C.)
- Gynecology and Obstetrics Department, University Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milan, Italy
| | - Carmelina Chiarello
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097 Milan, Italy;
| | - Paolo Ivo Cavoretto
- Gynecology and Obstetrics Department, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy; (G.G.); (R.V.); (M.C.); (M.P.); (M.P.); (S.L.S.); (P.I.C.)
- Gynecology and Obstetrics Department, University Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milan, Italy
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