Abnormal connection of the ductus venosus to a dilated coronary sinus imaged by prenatal echocardiography: Case report: The postnatal coronary sinus dilation caused by fetal venous anomalies

Anomalous drainage of the ductus venosus into the coronary sinus: prenatal ultrasound diagnosis utilizing two-dimensional and three-dimensional imaging techniques and differential diagnosis

BACKGROUND

Anomalous drainage of the ductus venosus (DV) into the coronary sinus (CS) is a rare fetal vascular anomaly that poses challenges for prenatal diagnosis. This study aimed to investigate the role of two-dimensional (2D) and three-dimensional (3D) ultrasound imaging, specifically spatiotemporal image correlation (STIC) technology, in improving the prenatal diagnosis of this anomaly.

METHODS

We retrospectively reviewed eight cases of fetuses diagnosed with anomalous DV drainage into the CS at Gansu Provincial Maternal and Child Health Hospital between September 2019 and September 2024. The gestational age of the fetuses ranged from 24 to 30 weeks. Ultrasound examinations, including 2D and Doppler imaging, along with HDlive Flow combined with STIC technology, were used for diagnosis. Differential diagnoses were made based on imaging findings. Descriptive statistics were employed to summarize the results.

RESULTS

Eight fetuses with anomalous DV drainage into the CS were identified. Of these, five cases were isolated anomalies, while three had associated malformations, such as aberrant right subclavian artery and right aortic arch. Dilated CS was observed in all cases, with an average inner diameter of 5.7 mm. STIC imaging successfully visualized the abnormal course of the DV, enhancing diagnostic confidence. Postnatal follow-up indicated favorable outcomes for most neonates (except for Case NO.3 and Case NO.7), although persistent CS dilation was observed in these cases, without significant hemodynamic compromise or clinical symptoms.

CONCLUSIONS

Prenatal diagnosis of anomalous DV drainage into the CS can be effectively achieved using 2D and 3D ultrasound, with STIC technology providing added diagnostic clarity. Early and accurate detection is crucial for ensuring appropriate clinical management and favorable outcomes. Ongoing surveillance of CS dilation in the postnatal period is recommended.