The learning curve for a fetal cardiac intervention team

Area of Science:

• Cardiology
• Fetal Medicine
• Minimally-Invasive Surgery

Background:

• Establishing a fetal cardiac interventional program involves complex procedures.
• Multidisciplinary teams face technical challenges during initial implementation.

Purpose of the Study:

• To describe the learning curve associated with a new minimally-invasive fetal cardiac interventional program.
• To assess the impact of practice on technical proficiency in fetal cardiac intervention.

Main Methods:

• Ten pregnant sheep underwent ultrasound-guided balloon valvuloplasty of the aortic valve.
• A consistent multidisciplinary team performed all procedures.
• Procedure time from needle insertion to left ventricle entry was recorded and analyzed using F-test.

Main Results:

• A significant decrease in procedure time was observed over the trial.
• Initial attempts averaged 12 minutes, improving to 1 minute by the final attempt (P = .003).

Conclusions:

• A notable learning curve exists for initiating minimally-invasive fetal cardiac intervention programs.
• Technical proficiency is attainable through dedicated practice.
• Animal models are recommended for training before human fetal interventions.