Hypoplastic Left Heart Syndrome: Is There a Role for Fetal Therapy?

Area of Science:

• Cardiology
• Fetal Medicine
• Pediatric Surgery

Background:

• Hypoplastic left heart syndrome (HLHS) is a severe congenital heart defect.
• Fetal cardiac defects can impede left heart growth, leading to HLHS.
• Atrial septum restriction in HLHS worsens prognosis via left atrial hypertension and pulmonary vascular remodeling.

Purpose of the Study:

• To review patient selection for fetal therapy in HLHS.
• To discuss the hemodynamic effects of fetal cardiac interventions.
• To cover the impact of maternal hyperoxygenation on fetal HLHS.

Main Methods:

• Literature review of fetal therapy for HLHS.
• Analysis of hemodynamic changes associated with interventions.
• Evaluation of maternal hyperoxygenation protocols.

Main Results:

• Fetal interventions and maternal hyperoxygenation are strategies to manage evolving or established HLHS.
• Patient selection is crucial for successful fetal therapy.
• Hemodynamic effects of interventions and hyperoxygenation vary and require careful consideration.

Conclusions:

• Fetal therapy offers potential to improve outcomes for HLHS.
• Invasive and non-invasive approaches require precise patient selection.
• Understanding hemodynamic effects is key to optimizing fetal treatment for HLHS.