[Fetal cardiac interventions - are we ready for them?]

Area of Science:

• Cardiology
• Fetal Medicine
• Interventional Cardiology

Background:

• Intrauterine fetal cardiac interventions are critical for managing congenital heart defects.
• Previous literature and training informed the development of intervention protocols.

Purpose of the Study:

• To analyze the types and methods of intrauterine fetal cardiac interventions performed.
• To assess the perinatal management of neonates undergoing these procedures.

Main Methods:

• Interventions were performed on fetuses with critical aortic stenosis, pulmonary stenosis, or restricted foramen ovale.
• Procedures included balloon aortic valvuloplasty, pulmonary valvuloplasty, balloon atrial septostomy, and atrial septal stent placement.
• Anesthesia protocols for both mother and fetus were carefully developed and optimized.

Main Results:

• A total of 42 interventions were performed on 35 fetuses between June 2011 and December 2013.
• Technical success rate was 97%, with 41 out of 42 procedures being successful.
• The anesthesia protocol was refined, transitioning to local anesthesia with intravenous sedation for the mother.

Conclusions:

• Intrauterine fetal cardiac interventions can be successfully and safely performed in Polish centers.
• These interventions improve fetal cardiac status and are safe for pregnant women.
• Neonates treated prenatally were generally in good condition upon referral to specialized centers.