Fetal aortic valvuloplasty as the first step in a complex therapeutic strategy.
Prenat Diagn
; 44(6-7): 739-746, 2024 06.
Article
em En
| MEDLINE
| ID: mdl-38666896
ABSTRACT
BACKGROUND:
Fetal aortic valvuloplasty (FAV) is proposed to prevent hypoplastic left heart syndrome due to fetal critical aortic stenosis.OBJECTIVE:
to report our experience on FAV as the first step in a complex therapeutic strategy.METHOD:
Series of patients with FAV over an 18-year period.RESULTS:
27 FAVs were performed in 26 fetuses, with technical success in 82% (22/27) and periprocedural fetal demise in 22% (6/27), decreasing to 15% in the second half-cohort. Loss to follow-up was due to birth or postnatal therapy in other centers (5) and termination of pregnancy (1), A normal-sized LV at birth was observed in 46% (6/13), 4 neonates underwent aortic valvuloplasty and 2 cardiac surgeries, with 5/6 achieving biventricular circulation at 28 days, and 3 transplant-free survival at mid-term follow-up. The 7/13 born with a borderline LV underwent LV rehabilitation strategy, with survival at 28 days in 4/7 and at mid-term in 3 one with biventricular circulation, one with a ventricle-and-a-half repair, and one lost to follow-up.CONCLUSION:
FAV was feasible in most cases, with no maternal complications, and biventricular circulation at 28 days in â¼40% of survivors. After FAV, a diverse range of postnatal cardiac interventions are performed, reflecting the challenging innovation in current cardiovascular therapy.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
Limite:
Adult
/
Female
/
Humans
/
Newborn
/
Pregnancy
Idioma:
En
Revista:
Prenat Diagn
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Argentina
País de publicação:
Reino Unido