A rare combination of pulmonary valve agenesis syndrome, X chromosome trisomy, and fetal chromosome 22 microdeletion in a patient with cardiac pathology. Literature review and clinical observation

Authors: Gasanova R.M.1 2, Yarygina T.A.1 3 4, Bolshakova A.S.2, Chernysheva S.G.1, Marzoeva О.V.1, Sipchenko E.V.1, Leonova E.I.1

Company: 1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
2 National Medical Research Center of Obstetrics and Gynecology named after Academician V.I. Kularov, Moscow, Russian Federation
3 Moscow Regional Scientific Research Institute of Obstetrics and Gynecology named after Academician V.I. Krasnopolsky, Moscow, Russian Federation
4 Peoples’ Friendship University of Russia named after Patrice Lumumba, Moscow, Russian Federation

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Type:  Case reports


DOI: https://doi.org/10.24022/1997-3187-2024-18S-S148-S156

For citation: Gasanova R.M., Yarygina T.A., Bolshakova A.S., Chernysheva S.G., Marzoeva О.V., Sipchenko E.V., Leonova E.I. A rare combination of pulmonary valve agenesis syndrome, X chromosome trisomy, and fetal chromosome 22 microdeletion in a patient with cardiac pathology. Literature review and clinical observation. Creative Cardiology. 2024; 18 (Special Issue): S148–S156 (in Russ.). DOI: 10.24022/1997-3187-2024-18S-S148-S156

Received / Accepted:  07.10.2024 / 25.10.2024

Keywords: X chromosome trisomy chromosome 22 deletion syndrome congenital heart disease maternal risk factors pulmonary artery valve agenesis right aberrant subclavian artery

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Abstract

This article presents a rare clinical case of fetal heart disease- pulmonary artery valve agenesis, combined with chromosome 22 deletion syndrome and chromosome X trisomy, while the pregnant woman herself had a cardiac pathology.

The rare clinical case presented in this publication highlights the importance of taking maternal risk factors into account when routing pregnant women for prenatal diagnosis.

A significant increase in the effectiveness of early prenatal screening in detecting cases of CHD in the fetus can be achieved by referring pregnant women to expert echocardiography in the first trimester, especially in the presence of pathology from the cardiovascular system.

As early as possible, the detection of cardiac malformations in the fetus provides an opportunity for a comprehensive examination, which must necessarily include an invasive genetic diagnosis.

References

  1. Healthcare in Russia. 2023: Statistical collection/Rosstat. Moscow, 2023 (in Russ.).
  2. Tumanova U.N., Shuvalova M.P., Schegolev A.I. Analysis of statistical indicators of congenital anomalies as causes of early neonatal death in the Russian Federation. Ros. Vestn. Perinatol. i Pediatr. 2018; 63:(6): 60–67 (in Russ.). DOI: 10.21508/1027–4065–2018–63–5–60–67
  3. Golukhova E.Z., Kim A.I., Zavalikhina T.V., Nefedova I.E., Chernogrivov A.E., Avakova S.A. Analysis of medical care for children with congenital heart defects in the Russian Federation and prerequisites for the creation of a register in the modern era of digital medical information systems. Creative cardiology. 2023; 17 (3): 315–321 (in Russ.). DOI: 10.24022/1997-3187-2023-17-3-315-321
  4. Marino B.S., Lipkin P.H., Newburger J.W., Peacock G., Gerdes M., Gaynor J.W. et al. American Heart Association Congenital Heart Defects Committee, Council on cardiovascular disease in the young, Council on cardiovascular nursing, and stroke Council. Neurodevelopmental outcomes in children with congenital heart disease: evaluation and management: a scientific statement from the American Heart Association. Circulation. 2012; 126 (9): 1143–72. DOI: 10.1161/CIR.0b013e318265ee8a
  5. Yarygina T.A., Gasanova R.M., Leonova E.I., Marzoeva O.V., Sypchenko E.V., Gus A.I. Prenatal detection of somatic pathology complicating the condition of newborns with congenital heart defects. Children’s Heart and Vascular Diseases. 2021; 18 (4): 269–280 (in Russ.). DOI: 10.24022/1810-0686-2021-18-4-269-280
  6. Yarygina T.A., Leonova E.I., Gasanova R.M., Marzoeva O.V., Sypchenko E.V., Gus A.I. Prenatal identification of factors associated with impaired psychomotor development in children with congenital heart disease. Children’s Heart and Vascular Diseases. 2022; 19 (4): 285–296 (in Russ.). DOI: 10.24022/1810-0686-2022-19-4-285-296
  7. Pak V.S., Tetruashvili N.K., Bokeriya E.L., Shubina Je,. Zaretskaya N.V., Bolshakova A.S., Lyushnina D.G., Kuznetsova M.V., Mikhailovskaya G.V., Sadelov I.O., Trofimov D.Yu. The role of chromosomal abnormalities in fetal congenital heart defects. Akusherstvo i Gynecologia/ Obstetrics and Gynecology. 2023; 10: 86–93 (in Russ.). DOI: 10.18565/aig.2023.220
  8. Carvalho J.S., Axt-Fliedner R., Chaoui R., Copel J.A., Cuneo B.F., Goff D. et al. ISUOG Practice Guidelines (updated): fetal cardiac screening. Ultrasound Obstet Gynecol. 2023; 61 (6): 788–803. DOI: 10.1002/uog.26224
  9. Moon-Grady A.J., Donofrio M.T., Gelehrter S., Hornberger L., Kreeger J., Lee W. et al. Guidelines and Recommendations for Performance of the Fetal Echocardiogram: An Update from the American Society of Echocardiography. J. Am. Soc. Echocardiogr. 2023; 36 (7): 679–723. DOI: 10.1016/j.echo.2023.04.014
  10. Emmanoulides G.C., Thanopoulos B, Siassi B., Fishbein M. “Agenesis” of ductus arteriosus associated with the syndrome of tetralogy of Fallot and absent pulmonary valve. Am. J. Cardiol. 1976; 37: 403–409.
  11. Lakier J.B., Stanger P., Heymann M.A., Hoffman J.I., Rudolph A.M. Tetralogy of Fallot with absent pulmonary valve. Natural history and hemodynamic considerations. Circulation. 1974; 50 (1): 167–175.
  12. Snir E., de Leval M.R., Elliott M.J., Stark J. Current surgical technique to repair Fallot’s tetralogy with absent pulmonary valve syndrome. Ann. Thorac. Surg. 1991; 51 (6): 979–982.
  13. Bahaaldin A., Williams W.G, Hua Zhongdong, Cai Sally, Karamlou Tara, Chan Chee Ching, et al. Surgical outcomes in the treatment of patients with tetralogy of Fallot and absent pulmonary valve. Eur. J. Cardio Thorac. Surg. 2007; 31 (3): 354–359.
  14. Chevers N.A. Collection of facts illustrative of the morbid conditions of the pulmonary artery, as bearing upon the treatment of cardiac and pulmonary diseases. Lond. Med. Gaz. 1847; 38: 828–835.
  15. Rose J.S., Levin D.C., Goldstein S. et al. Congenital absence of the pulmonary valve associated with congenital aplasia of the thymus (DiGeorge’s syndrome). Am. J. Roentgenol. Radium. Ther. Nucl. Med. 1974; 122: 97–102.
  16. Volpe P., Paladini D., Marasini M., Buonadonna A.L., Russo M.G., Caruso G. et al. Characteristics, associations and outcome of absent pulmonary valve syndrome in the fetus. Ultrasound Obstet Gynecol. 2004; 24 (6): 623–628. DOI: 10.1002/uog.1729
  17. Maya I., Kahana S., Yeshaya J., Tenne T., Yacobson S., Agmon-Fishman I. et al. Chromosomal microarray analysis in fetuses with aberrant right subclavian artery. Ultrasound. Obstet. Gynecol. 2017; 49 (3): 337–341. DOI: 10.1002/uog.15935
  18. Martínez-Payo C., Suanzes E., Gómez-Manrique A., Arranz A., Pérez-Medina T. Aberrant right subclavian artery as soft marker in the diagnosis of trisomy 21 during the first trimester of pregnancy. Arch. Gynecol. Obstet. 2022; 305 (6): 1439–1444. DOI: 10.1007/s00404-021-06221-5
  19. Jacobs P.A. The incidence and etiology of sex chromosome abnormalities in man. Birth. Defects Orig. Artic. Ser. 1979; 15: 3–14.
  20. MacDonald M., Hassold T., Harvey J., Wang L.H., Morton N.E., Jacobs P. The origin of 47,XXY and 47,XXX aneuploidy: heterogeneous mechanisms and role of aberrant recombination. Hum. Mol. Genet. 1994, 3: 1365–1371.
  21. Nielsen J., Wohlert M. Sex chromosome abnormalities found among 34,910 newborn children: results from a 13-year incidence study in Arhus, Denmark. Birth. Defects Orig. Artic. Ser. 1990; 26: 209–232.
  22. Otter M., Schrander-Stumpel C.T., Didden R., Curfs L.M. The psychiatric phenotype in triple X syndrome: new hypotheses illustrated in two cases. Dev. Neurorehabil. 2012; 15 (3): 233–238. DOI: 10.3109/17518423.2012.655799
  23. Aldarwish M., Alaithan I., Alawami F. Aplastic anemia in triple X syndrome. Children (Basel). 2023; 10 (1): 100. DOI: 10.3390/children10010100
  24. Tartaglia N.R., Howell S., Sutherland A., Wilson R., Wilson L. A review of trisomy X (47,XXX). Orphanet. J. Rare Dis. 2010; 11 (5): 8. DOI: 10.1186/1750-1172-5-8
  25. Sahin Uysal N., Gulumser C., Yanik F.F. EP04.12: Triple X syndrome associated with central nervous system anomalies and cardiac anomaly. Ultrasound. Obstet. Gynecol. 2015; 46: 197–198. DOI: /10.1002/uog.15550
  26. Ravens U. Sex differences in cardiac electrophysiology. Can. J. Physiol. Pharmacol. 2018; 96 (10): 985–990. DOI: 10.1139/cjpp-2018-0179
  27. Cirillo A., Lioncino M., Maratea A., Passariello A., Fusco A., Fratta F. Clinical Manifestations of 22q11.2 deletion syndrome. Heart Fail. Clin. 2022; 18 (1): 155–164. DOI: 10.1016/j.hfc.2021.07.009
  28. Besseau-Ayasse J., Violle-Poirsier C., Bazin A. et al. A French collaborative survey of 272 fetuses with 22q11.2 deletion: ultrasound findings, fetal autopsies and pregnancy outcomes. Prenat. Diagn. 2014; 34 (5): 424–430. DOI: 10.1002/pd.4321
  29. Szczawi´nska-Popłonyk A., Schwartzmann E., Chmara Z., Głukowska A., Krysa T., Majchrzycki M. Chromosome 22q11.2 deletion syndrome: a comprehensive review of molecular genetics in the context of multidisciplinary clinical approach. Int. J. Mol. Sci. 2023; 24: 8317.
  30. Michaelovsky E., Frisch A., Carmel M., Patya M., Zarchi O., Green T. Genotype-phenotype correlation in 22q11.2 deletion syndrome. BMC Med. Genet. 2012; 13: 122.
  31. Portnoï M.F., Joyé N., Gonzales M., Demczuk S., Fermont L, Gaillard G., Bercau G., Morlier G., Taillemite J.L. Prenatal diagnosis by FISH of a 22q11 deletion in two families. J. Med. Genet. 1998; 35 (2): 165–168. DOI: 10.1136/jmg.35.2.165
  32. Gasanova R.M., Pitirimova O.A., Yarygina T.A., Leonova E.I., Marzoeva O.V., Sypchenko E.V. Report on the scientific and practical activities of the Perinatal Cardiology Center of the Bakoulev National Medical Research Center for Cardiovascular Surgery for 2021. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2022; 23 (3): 359–364 (in Russ.). DOI: 10.24022/1810-0694-2022-23-3-359-364

About Authors

  • Rena M. Gasanova, Dr. Med. Sci., Research Associate, Cardiologist, Head of Department; ORCID
  • Tamara A. Yarygina, Cand. Med. Sci., Associated Professor, Specialist of ultrasound diagnostics, Researcher; ORCID
  • Anna S. Bolshakova, Geneticist; ORCID
  • Svetlana G. Chernysheva, Cardiologist; ORCID
  • Olga V. Marzoeva, Cand. Med. Sci., Researcher; ORCID
  • Elena V. Sypchenko, Cand. Med. Sci.; ORCID
  • Leonova Elena Igorevna, Specialist of ultrasound diagnostics; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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