Document Detail


Fetal intervention in right outflow tract obstructive disease: selection of candidates and results.
MedLine Citation:
PMID:  22928144     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
E Gómez Montes; I Herraiz; A Mendoza; A Galindo
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Publication Detail:
Type:  Journal Article     Date:  2012-08-15
Journal Detail:
Title:  Cardiology research and practice     Volume:  2012     ISSN:  2090-0597     ISO Abbreviation:  Cardiol Res Pract     Publication Date:  2012  
Date Detail:
Created Date:  2012-08-28     Completed Date:  2012-08-30     Revised Date:  2013-03-14    
Medline Journal Info:
Nlm Unique ID:  101516542     Medline TA:  Cardiol Res Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  592403     Citation Subset:  -    
Affiliation:
Fetal 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, Spain.
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