{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T15:51:59Z","timestamp":1791129119046,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>In dextro\u2010transposition of the great arteries (D\u2010TGA) and double outlet right ventricle with subpulmonary ventricular septal defect (DORV\u2010SPV) and predicted transposition physiology, the presence of associated lesions, such as ventricular septal defect (VSD), coarctation of the aorta (CoA) or pulmonary stenosis (PS), impacts prenatal counseling and complicates neonatal surgery. This study aimed to evaluate the diagnostic accuracy of fetal echocardiography (FE) and its ability to predict the postnatal surgical plan in fetuses with D\u2010TGA or DORV\u2010SPV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a single\u2010center retrospective cohort study of fetuses with D\u2010TGA or DORV\u2010SPV who were liveborn,\u00a0had a recorded plan for postnatal intervention and were managed at Lucile Packard Children's Hospital, Palo Alto, CA, USA, between January 2013 and January 2024. In cases with serial FE examinations, all available FE reports were included in the analysis, in addition to the first postnatal echocardiogram report. For echocardiograms with incomplete measurement data, a single reader retrospectively obtained FE and postnatal echocardiogram measurements while blinded to clinical outcomes. Prenatal predictions for postnatal surgical repair were extracted from the fetal cardiology consultation notes and postnatal clinical data were obtained by chart review. Final FE and postnatal echocardiogram diagnoses, as well as prenatal surgical\u2010plan predictions and subsequent postnatal surgical repairs performed, were compared and the percentage concordance was calculated to obtain FE diagnostic accuracy. Receiver\u2010operating\u2010characteristics (ROC) curves were generated to evaluate the association of FE aortic and pulmonary measurements with postnatal CoA repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 99 fetuses, of which 45 were diagnosed postnatally with simple D\u2010TGA with no associated lesions (i.e. D\u2010TGA with intact ventricular septum), 38 with complex D\u2010TGA with associated lesions and 15 with DORV, and one neonate was diagnosed prenatally with DORV\u2010SPV but postnatally diagnosed with truncus arteriosus. In the majority (65%) of patients, serial FE was performed. The percentage concordance between fetal and postnatal echocardiogram diagnoses was high for simple D\u2010TGA (95% (42\/44)) and D\u2010TGA with VSD and PS (100% (3\/3)). The concordance was progressively lower for diagnoses of D\u2010TGA with VSD (93% (25\/27)), DORV\u2010SPV (60% (3\/5)), DORV\u2010SPV with CoA (40% (4\/10)), D\u2010TGA with VSD and CoA (29% (2\/7)), D\u2010TGA with isolated CoA (0% (0\/2)) and DORV\u2010SPV with PS (0% (0\/1)). Similarly, surgical\u2010plan accuracy between prenatal prediction and postnatal repair performed was highest for cases of simple D\u2010TGA and D\u2010TGA with VSD and PS, while it was lower for other diagnoses. Qualitative descriptions of VSD size changed frequently over serial FE examinations, with VSDs generally described as larger on later FE. However, between the final FE and postnatal echocardiogram, in those with discordance,\u00a0the description of VSD size usually became smaller. Only 50% of small VSDs identified on postnatal echocardiography required repair. All patients who underwent postnatal repair of CoA had a VSD present. All area under the ROC curve values for aortic measurements and for ratios of aortic\u2010to\u2010pulmonary dimensions in predicting the need for postnatal CoA repair were greater than 0.9.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Challenges remain in the accurate diagnosis and prediction of the postnatal surgical plan in fetuses with complex D\u2010TGA and DORV\u2010SPV. The assessment of qualitative VSD size description changed frequently over serial FE evaluations, and between final FE and postnatal echocardiogram, with small defects often not requiring repair. Aortic and aortic\u2010to\u2010pulmonary ratio measurements in fetuses with D\u2010TGA or DORV\u2010SPV appear to have improved the discriminatory ability in identifying cases that undergo postnatal CoA repair relative to fetuses with isolated CoA. \u00a9 2026 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.70169","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T13:21:16Z","timestamp":1769779276000},"page":"79-87","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Accuracy of fetal echocardiography in detecting lesions associated with, and predicting surgical plan for, dextro\u2010transposition of the great arteries and double outlet right ventricle with subpulmonary ventricular septal defect and predicted transposition physiology"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6933-0882","authenticated-orcid":false,"given":"H.","family":"Chandrasekar","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Lucile Packard Children's Hospital Stanford University  Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kaplinski","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Lucile Packard Children's Hospital Stanford University  Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8806-1398","authenticated-orcid":false,"given":"S. A.","family":"Maskatia","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Lucile Packard Children's Hospital Stanford University  Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9197-1854","authenticated-orcid":false,"given":"M. J.","family":"Beattie","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Lucile Packard Children's Hospital Stanford University  Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5805-769X","authenticated-orcid":false,"given":"D. Y.","family":"Ho","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Lucile Packard Children's Hospital Stanford University  Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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