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1Department of Prenatal Medicine, Women's and Children's Hospital Linz, Linz, Austria. wolfgang.arzt@gespag.at
Prenatal Diagnosis
|June 15, 2011
Summary
Fetal cardiac interventions for critical aortic and pulmonary stenosis can prevent single-ventricle circulation. Successful procedures can reverse heart failure and lead to biventricular outcomes in many cases.
Area of Science:
- Cardiology
- Fetal Medicine
- Congenital Heart Disease
Background:
- Critical fetal aortic stenosis (AS) and pulmonary stenosis/atresia can lead to single-ventricle physiology.
- Intrauterine interventions offer a potential to alter the natural progression of these defects.
Purpose of the Study:
- To review global experience with fetal cardiac interventions for critical AS and pulmonary stenosis/atresia.
- To assess the potential of these interventions to prevent single-ventricle circulation and improve outcomes.
Main Methods:
- Review of worldwide data on fetal cardiac interventions for critical AS and pulmonary stenosis/atresia.
- Analysis of cases undergoing intrauterine surgical or interventional procedures.
Main Results:
- Fetal cardiac interventions can potentially alter the natural course of critical AS and pulmonary stenosis/atresia.
- In carefully selected cases, interventions can reverse end-stage heart failure.
- Successful interventions provide a biventricular outcome in approximately two-thirds of cases postnatally.
Conclusions:
- Intrauterine dilation for critical fetal AS and pulmonary stenosis/atresia is a viable strategy.
- Fetal cardiac interventions can prevent the progression to single-ventricle circulation.
- These procedures offer a chance for biventricular outcomes in selected infants with congenital heart defects.
