{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T15:40:16Z","timestamp":1780414816269,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe the fetal echocardiographic features of a double aortic arch (DAA) and secondly, to assess the performance of these features to differentiate between a right aortic arch with left duct (RAA\u2010LD) in a blinded cohort of vascular rings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Review of records to identify surgically confirmed cases of DAA diagnosed prenatally from 2014 to 2018 (cohort\u2010A). Prenatal echocardiograms were reviewed and the segments of the aortic arches anterior and posterior to the trachea, aortic isthmuses and the presence\/absence of the Z\u2010sign were described. The utility of these markers were assessed in a separate cohort (B) of fetuses with surgically confirmed cases of DAA or RAA\u2010LD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cohort\u2010A comprised 34 cases with DAA; there was a dominant RAA in 32\/34 (94%) and balanced left aortic arch (LAA) and RAA in two cases. The proximal LAA was seen in 29\/34 (85%), distal LAA in 15\/34 (44%) and the LAA aortic isthmus in 4\/34 (12%). The \u201cZ\u201d configuration was present in 29\/34 (85%) cases. The most predictive marker for DAA in cohort\u2010B was the Z\u2010sign (sensitivity: 100%, specificity: 81%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The \u201cZ\u201d sign is a useful differentiator between RAA\u2010LD and DAA. The absence of visualization of the left aortic isthmus does not preclude the presence of a DAA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6104","type":"journal-article","created":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T06:49:35Z","timestamp":1642747775000},"page":"419-427","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Fetal echocardiographic markers to differentiate between a right and double aortic arch"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1739-4726","authenticated-orcid":false,"given":"Milou P. 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