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Right superior vena cava (RSVC) draining into the left atrium, causing hypoxemia, represents a very rare congenital malformation which has not previously been described in the fetus. We describe a case in which fetal echocardiography at 22 weeks' gestation revealed an enlarged superior vena cava connecting abnormally with a mildly enlarged left atrium. Neonatal transthoracic echocardiography confirmed the diagnosis and showed an abnormal connection of the right pulmonary veins to the RSVC. Right-to-left shunt due to anomalous drainage of the RSVC into the left atrium associated with an atrial septal defect and anomalous pulmonary venous return were diagnosed on echocardiography and confirmed by angiography. The newborn was hemodynamically stable at birth and at the 1-year follow-up. [ABSTRACT FROM AUTHOR]

An abstract of the conference paper "Prenatal diagnosis improves short term outcome in Transposition of the Great Arteries," by M.G. Russo and colleagues is presented.

The physiological importance of the right ventricle (RV) has been underestimated over the past years. Finally in the early 1950s through the 1970s, cardiac surgeons recognized the importance of RV function. Since then, the importance of RV function has been recognized in many acquired cardiac heart disease. RV can be mainly or together with left ventricle (LV) affected by inherited or acquired cardiomyopathy. In fact, RV morphological and functional remodeling occurs more common during cardiomyopathies than in ischemic cardiomyopathies and more closely parallels LV dysfunction. Moreover, there are some cardiomyopathy subtypes showing a predominant or exclusive involvement of the RV, and they are probably less known by cardiologists. The clinical approach to right ventricular cardiomyopathies is often challenging. Imaging is the first step to raise the suspicion and to guide the diagnostic process. In the differential diagnosis, cardiologists should consider athlete's heart, congenital heart diseases, multisystemic disorders, and inherited arrhythmias. However, a multiparametric and multidisciplinary approach, involving cardiologists, experts in imaging, geneticists, and pathologists with a specific expertise in these heart muscle disorders is required., (© 2014, Wiley Periodicals, Inc.)

Purpose: To analyze pulsed-Doppler tissue imaging (DTI) of the right ventricular (RV) tricuspid annulus and left ventricular (LV) mitral annulus in patients paced in the DDD mode at three different pacing modes as compared with healthy subjects, and to investigate possible physiologic interaction between the RV and LV in this subgroup of patients., Methods: We selected a population of 22 subjects with pacemakers (PM) for atrioventricular (AV) block and/or sick sinus syndrome and compared them to 20 healthy subjects. Standard echo Doppler and DTI parameters were measured at baseline (heart rate [HR] 70 beats/min; AV delay 125 msec) and after at least 5 minutes of constant stimulation at two different pacing modes: (1) HR 70 beats/min, AV delay 188 msec, and (2) HR 89 beats/min, AV delay 125 msec. LV stroke volume was obtained by LV outflow Doppler method., Results: In the PM group, RV and LV annulus exhibited significantly higher peak systolic (S(m)) and early (E(m)) diastolic wall velocities than controls. In the PM population, LV stroke volume was strongly associated to RV E(m) peak velocity (r = 0.83; P < 0.00001) and RV S(m) peak velocity (r = 0.81; P < 0.0001). These associations between LV stroke volume and RV DTI parameters remained significant even after increase of HR and AV delay in the pacing modalities. Moreover, univariate relations were found in the PM group between DTI indexes of RV tricuspid annulus and the homologous indexes of LV mitral annulus. In a multiple linear regression analysis, both RV E(m) (P < 0.001) and RV S(m) (P < 0.001) were related independently to LV stroke volume (cumulative R(2) = 0.85, P < 0.00001)., Conclusions: Our findings suggest the usefulness of pulsed-DTI to display physiologic ventricular interaction in patients with PM. Therefore, DTI may be taken into account as a valuable supporting tool to predict LV systolic performance and to select the most appropriate pacing mode in individual PM patients.