Fetal interventions for structural heart disease

Fetal cardiac intervention (FCI) offers the potential to alter in utero anatomy and physiology. For aortic stenosis with evolving hypoplastic left heart syndrome and pulmonary atresia with intact ventricular septum with evolving hypoplastic right heart syndrome, FCI may result in maintenance of a bi...

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Bibliographic Details
Published in:Echocardiography (Mount Kisco, N.Y.) N.Y.), 2017-12, Vol.34 (12), p.1834-1841
Main Authors: Schidlow, David N., Freud, Lindsay, Friedman, Kevin, Tworetzky, Wayne
Format: Article
Language:English
Subjects:
congenital heart defects
Echocardiography - methods
Female
fetal echocardiography
Fetal Heart - diagnostic imaging
Heart Defects, Congenital - diagnostic imaging
Heart Defects, Congenital - therapy
Humans
Pregnancy
Ultrasonography, Prenatal - methods
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Summary:Fetal cardiac intervention (FCI) offers the potential to alter in utero anatomy and physiology. For aortic stenosis with evolving hypoplastic left heart syndrome and pulmonary atresia with intact ventricular septum with evolving hypoplastic right heart syndrome, FCI may result in maintenance of a biventricular circulation, thus avoiding single‐ventricle palliation and its attendant complications. In the case of hypoplastic left heart syndrome with intact atrial septum, FCI may ameliorate in utero pathophysiology and portend a more favorable postnatal prognosis. In all cases, a detailed fetal echocardiographic assessment to identify the appropriate FCI candidate is essential. This article reviews the three aforementioned lesions for which FCI can be considered. The pathophysiology and rationale for intervention, echocardiographic assessment, patient selection criteria, and outcomes for each lesion will be reviewed. A primary focus will be the echocardiographic evaluation of each lesion.
ISSN:0742-2822
1540-8175
DOI:10.1111/echo.13667