Fetal echocardiography: new grounds to explore during fetal cardiac intervention

Over the past decade, revolutionary advances in ultrasound imaging technology have allowed the study of the evolution of congenital heart disease during fetal life. The frustration arising from watching the prenatal progression of severe semilunar valve obstructions and therapy-refractory fetal arrhythmias has prompted the interest in developing procedures for fetal cardiac intervention. Ultrasound techniques as the primary diagnostic and monitoring modalities in fetal medicine will play a key role in defining patient groups, peri-interventional assessment of fetal hemodynamics, and monitoring during these procedures. The purpose of this article is to provide pediatric cardiologists and perinatal medicine specialists an overview over the various technical approaches at fetal cardiac intervention and the special tasks that fetal echocardiography will have to accomplish. It also aims at illustrating the potential of fetal echocardiography for fetal selection.