Fetal Intervention in Right Outflow Tract Obstructive Disease: Selection of Candidates and Results
Objectives. To describe the process of selection of candidates for fetal cardiac intervention (FCI) in fetuses diagnosed with pulmonary atresia-critical stenosis with intact ventricular septum (PA/CS-IVS) and report our own experience with FCI for such disease. Methods. We searched our database for...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2012/592403 |
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| author | E. Gómez Montes I. Herraiz A. Mendoza A. Galindo |
| author_facet | E. Gómez Montes I. Herraiz A. Mendoza A. Galindo |
| author_sort | E. Gómez Montes |
| collection | DOAJ |
| description | Objectives. To describe the process of selection of candidates for fetal cardiac intervention (FCI) in fetuses diagnosed with pulmonary atresia-critical stenosis with intact ventricular septum (PA/CS-IVS) and report our own experience with FCI for such disease. Methods. We searched our database for cases of PA/CS-IVS prenatally diagnosed in 2003–2012. Data of 38 fetuses were retrieved and analyzed. FCI were offered to 6 patients (2 refused). In the remaining it was not offered due to the presence of either favourable prognostic echocardiographic markers (n=20) or poor prognostic indicators (n=12). Results. The outcome of fetuses with PA/CS-IVS was accurately predicted with multiparametric scoring systems. Pulmonary valvuloplasty was technically successful in all 4 fetuses. The growth of the fetal right heart and hemodynamic parameters showed a Gaussian-like behaviour with an improvement in the first weeks and slow worsening as pregnancy advanced, probably indicating a restenosis. Conclusions. The most likely type of circulation after birth may be predicted in the second trimester of pregnancy by means of combining cardiac dimensions and functional parameters. Fetal pulmonary valvuloplasty in midgestation is technically feasible and in well-selected cases may improve right heart growth, fetal hemodynamics, and postnatal outcome. |
| format | Article |
| id | doaj-art-a53ed42922244b07b85bbe64ef05815f |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-a53ed42922244b07b85bbe64ef05815f2025-02-03T01:21:18ZengWileyCardiology Research and Practice2090-80162090-05972012-01-01201210.1155/2012/592403592403Fetal Intervention in Right Outflow Tract Obstructive Disease: Selection of Candidates and ResultsE. Gómez Montes0I. Herraiz1A. Mendoza2A. Galindo3Fetal Medicine Unit-Red de Investigación en Salud Materno-Infantil y del Desarrollo (SAMID), Department of Obstetrics and Gynaecology, Hospital Universitario “12 de Octubre”, Universidad Complutense, 28041 Madrid, SpainFetal Medicine Unit-Red de Investigación en Salud Materno-Infantil y del Desarrollo (SAMID), Department of Obstetrics and Gynaecology, Hospital Universitario “12 de Octubre”, Universidad Complutense, 28041 Madrid, SpainPediatric Heart Institute-SAMID, Department of Pediatrics, Hospital Universitario “12 de Octubre”, Universidad Complutense, 28041 Madrid, SpainFetal Medicine Unit-Red de Investigación en Salud Materno-Infantil y del Desarrollo (SAMID), Department of Obstetrics and Gynaecology, Hospital Universitario “12 de Octubre”, Universidad Complutense, 28041 Madrid, SpainObjectives. To describe the process of selection of candidates for fetal cardiac intervention (FCI) in fetuses diagnosed with pulmonary atresia-critical stenosis with intact ventricular septum (PA/CS-IVS) and report our own experience with FCI for such disease. Methods. We searched our database for cases of PA/CS-IVS prenatally diagnosed in 2003–2012. Data of 38 fetuses were retrieved and analyzed. FCI were offered to 6 patients (2 refused). In the remaining it was not offered due to the presence of either favourable prognostic echocardiographic markers (n=20) or poor prognostic indicators (n=12). Results. The outcome of fetuses with PA/CS-IVS was accurately predicted with multiparametric scoring systems. Pulmonary valvuloplasty was technically successful in all 4 fetuses. The growth of the fetal right heart and hemodynamic parameters showed a Gaussian-like behaviour with an improvement in the first weeks and slow worsening as pregnancy advanced, probably indicating a restenosis. Conclusions. The most likely type of circulation after birth may be predicted in the second trimester of pregnancy by means of combining cardiac dimensions and functional parameters. Fetal pulmonary valvuloplasty in midgestation is technically feasible and in well-selected cases may improve right heart growth, fetal hemodynamics, and postnatal outcome.http://dx.doi.org/10.1155/2012/592403 |
| spellingShingle | E. Gómez Montes I. Herraiz A. Mendoza A. Galindo Fetal Intervention in Right Outflow Tract Obstructive Disease: Selection of Candidates and Results Cardiology Research and Practice |
| title | Fetal Intervention in Right Outflow Tract Obstructive Disease: Selection of Candidates and Results |
| title_full | Fetal Intervention in Right Outflow Tract Obstructive Disease: Selection of Candidates and Results |
| title_fullStr | Fetal Intervention in Right Outflow Tract Obstructive Disease: Selection of Candidates and Results |
| title_full_unstemmed | Fetal Intervention in Right Outflow Tract Obstructive Disease: Selection of Candidates and Results |
| title_short | Fetal Intervention in Right Outflow Tract Obstructive Disease: Selection of Candidates and Results |
| title_sort | fetal intervention in right outflow tract obstructive disease selection of candidates and results |
| url | http://dx.doi.org/10.1155/2012/592403 |
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