The three-vessels and tracheal view in early prenatal diagnosis of cardiac defects

Objective: To describe our experience with late first and early second trimester, prenatal diagnosis of abnormalities in the three-vessels and tracheal view (3VT) of the heart, utilizing high-resolution ultrasonography and color Doppler techniques. Materials and Methods: Fetuses with structural heart defects detected at late first and early second-trimester prenatal screening, which were diagnosed with an abnormality on the 3VT. Color Doppler was added in all cases. All patients received genetic counselling and pediatric cardiology consultation. Results: Twenty-one fetuses had an abnormality detected on the three-vessels and tracheal view. The median gestational age was 15 weeks (range 12-18). Lesions diagnosed included abnormal aortic size (hypoplastic left heart syndrome, narrow aorta, coarctation of the aorta); right aortic arch; abnormal pulmonary artery size (tetralogy of Fallot, pulmonary atresia); abnormal vessels arrangement (transposition of the great arteries); two vessels; four vessels (persistent left superior vena cava); and double outlet right ventricle. Application of color Doppler improved diagnosis in cases involving stenotic or atretic valves and aided in determining ductal flow. Conclusion: The three-vessels and tracheal view is efficient in late first and early second trimester prenatal diagnosis of cardiac defects, which involve the outflow tracts and the aortic arch, enabling early identification of critical heart defects. Addition of color Doppler aids and further contributes to the diagnosis. We suggest that examination of the three-vessels and tracheal view and color Doppler application should be considered in every low and high-risk prenatal sonographic evaluation.