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
Related Documents :
21823389 - Failure to ventilate with supraglottic airways after drowning.
19158399 - Renal nhe3 and napi2 partition into distinct membrane domains.
7141609 - Mechanisms for the elevation of blood pressure in human renal disease. preliminary report.
16202699 - Renovascular hypertension: current concepts.
8558479 - The effects of systemic hypoxia on renal function in the anaesthetized rat.
12201929 - Renal water and sodium handling during gradated unilateral ureter obstruction.
7836179 - Stability of alveolar capillary opening pressures.
11333159 - Allopurinol enhances adenine nucleotide levels and improves myocardial function in isol...
6727409 - Hemodynamic effect of isoprenaline and dobutamine immediately after correction of tetra...
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.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Comparative effectiveness of antibiotic treatment strategies for pediatric skin and soft-tissue infe...
Next Document:  Anogenital Human Papillomavirus in Sexually Abused and Nonabused Children: A Multicenter Study.