Document Detail


Use of a Pressure Guidewire in Fetal Cardiac Intervention for Critical Aortic Stenosis.
MedLine Citation:
PMID:  21844059     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Fetal cardiac intervention for critical aortic stenosis (AS) with evolving hypoplastic left heart syndrome is performed in an attempt to maintain a biventricular circulation postnatally. The procedure has been hindered by technical challenges and poor candidate selection. We report here the novel use of a pressure guidewire during aortic valvuloplasty in a fetus at 21 weeks' gestation with critical AS and evolving hypoplastic left heart syndrome. Use of a pressure guidewire during fetal cardiac intervention offers several potential advantages over existing protocols. This technique augments fetal ultrasound as it relates to operator awareness of catheter and wire position (with continuous monitoring of pressure waveforms), improves on intraprocedural fetal hemodynamic monitoring and responsiveness to resuscitation, and provides a rich new data set of invasive fetal hemodynamics. This data set offers tremendous potential with regards to improving candidate selection and postintervention prognostication. In addition, we provide the first, to our knowledge, characterization of intracardiac pressures in a human fetus with congenital heart disease. Given the realized and potential benefits associated with this technique, use of a pressure guidewire may become standard of care for all fetal cardiac interventions.
Authors:
Bryan H Goldstein; Carlen G Fifer; Aimee K Armstrong; Sarah K Gelehrter; Marjorie C Treadwell; Cosmas van de Ven; Albert P Rocchini
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-15
Journal Detail:
Title:  Pediatrics     Volume:  -     ISSN:  1098-4275     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Cardiology, Department of Pediatrics, and.
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