Holmes Heart-A simple antenatal diagnosis of a complex cardiac anomaly? Fetal echocardiographic findings and review

Double inlet left ventricle as a rare cardiac malformation comprises a broad spectrum of anatomic variants making its correct antenatal diagnosis challenging. We report on echocardiographic findings of three fetuses found to have a less frequent morphologic subgroup of double inlet left ventricle, namely Holmes heart, characterized by a single (left) ventricle connected to both atrioventricular orifices and normally related arteries. We addressed the pre- and perinatal management as well as additional abnormalities and discussed our experiences together with what is known from current literature.