OP-001 Fetal branching anomalies of the aortic arch and vascular rings: an experience of a single Italian reference center

The aim of this study is to analyze concordance between fetal and neonatal diagnosis of branching anomalies of the aortic arch and vascular rings and their clinical outcome in a single Italian reference center

We conducted a retrospective study from January 2021 to December 2023.The prenatal diagnosis was confirmed by postnatal echocardiogram and in cases of suspected vascular rings with a computed tomography (CT)

4711 fetal echocardiography were performed and branching anomalies of the aortic arch or vascular rings were suspected in 103 cases. 62 cases were an incomplete vascular ring aberrant right subclavian artery (ARSA); 1 case was associated with prenatal diagnosis of Tetralogy of Fallot (ToF); 16 cases were isolated right aortic arch (RAA) and 25 were RAA with aberrant left subclavian artery (ALSA) of which 1 case was associated with ToF and persistent left superior vena cava (PLSVC). Only 12 amniocenteses were performed, 75% results with normal karyotype and 25% with chromosomal/genetic abnormalities. In postnatal series, concordance between prenatal diagnoses was 75% for RAA, and 100% for RAA + ALSA. In postnatal, 2 cases of prenatal diagnosis of RAA were associated with ALSA and 2 cases with double aortic arch, but in 1 of these, a CT with conclusive diagnosis of RAA + ALSA was performed

In our series, the most common anomaly was isolated ARSA without cases of dysphagia lusoria in newborns. Our genetic evaluation is suboptimal. In the absence of major congenital heart disease association or karyotype anomalies counseling should be reassuring to parents.