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Fetal cardiac intervention-Perspectives from a single center
Stephanie H Guseh1, Kevin G Friedman2, Louise E Wilkins-Haug1
1Division of Maternal Fetal Medicine, Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Prenatal Diagnosis
|December 26, 2019
Summary
Fetal cardiac intervention for hypoplastic left heart syndrome (HLHS) has improved significantly. Advances in techniques and imaging now demonstrate the safety and impact of in utero procedures for developing fetuses.
Area of Science:
- Cardiovascular Surgery
- Fetal Medicine
- Pediatric Cardiology
Background:
- Fetal cardiac intervention was proposed in the 1990s for fetal aortic stenosis and hypoplastic left heart syndrome (HLHS).
- Early attempts at fetal aortic valvuloplasty had high morbidity and mortality rates.
- Recent advancements have revitalized the procedure.
Purpose of the Study:
- To document the safety of in utero intervention for developing HLHS.
- To understand the impact of midgestation intervention on HLHS.
- To explore future refinements including genetics, biomarkers, and stem cell technology.
Main Methods:
- Improvements in imaging, anesthesia, balloon catheters, and surgical techniques were implemented.
- Two decades of collaborative experience were analyzed.
- Focus on in utero intervention during midgestation.
Main Results:
- The safety of in utero intervention has been documented.
- A better understanding of the impact of midgestation intervention on developing HLHS has been achieved.
Conclusions:
- Fetal cardiac intervention for HLHS has evolved significantly.
- Ongoing research aims to further refine procedures for better patient outcomes.
- Future directions include genetic research, biomarkers, and stem cell integration.
