Fetal interventions for structural heart disease |
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| Authors: | David N Schidlow MD MMus Lindsay Freud MD Kevin Friedman MD Wayne Tworetzky MD |
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| Institution: | 1. Children's National Heart Institute, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC, USA;2. Division of Pediatric Cardiology, Columbia University Medical Center, New York‐Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA;3. Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts;4. Department of Pediatrics, Harvard Medical School, Boston, Massachusetts |
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| Abstract: | 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. |
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| Keywords: | congenital heart defects fetal echocardiography |
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