| World experience of percutaneous ultrasound-guided balloon valvuloplasty in human fetuses with severe aortic valve obstruction. | |
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MedLine Citation:
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PMID: 10802006 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Prenatal alleviation of severe fetal aortic valve obstructions by percutaneous ultrasound-guided balloon valvuloplasty has been performed to improve the fate of affected fetuses. The purpose of this study was to analyze the current world experience of these procedures in human fetuses. Data from 12 human fetuses were available for analysis. The mean gestational age at intervention was 29.2 weeks (range 27 to 33). The mean time period between initial presentation and intervention was 3.3 weeks (range 3 days to 9 weeks). Technically successful balloon valvuloplasties were achieved in 7 fetuses, none of whom had an atretic valve. Only 1 of these fetuses remains alive today. Of the 5 remaining technical failures, 1 patient with severe aortic stenosis underwent successful postnatal intervention and remains alive. Six patients who survived prenatal intervention died from cardiac dysfunction or at surgery in the first days or weeks after delivery. Four fetuses died early within 24 hours after the procedure, 1 from a bleeding complication, 2 from persistent bradycardias, and 1 at valvotomy after emergency delivery. Thus, the early clinical experience of percutaneous ultrasound-guided fetal balloon valvuloplasty in human fetuses with severe aortic valve obstruction has been poor due to selection of severe cases, technical problems during the procedure, and high postnatal operative mortality in fetuses who survived gestation. Improved patient selection and technical modifications in interventional methods may hold promise to improve outcome in future cases. |
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Authors:
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T Kohl; G Sharland; L D Allan; U Gembruch; R Chaoui; L M Lopes; P Zielinsky; J Huhta; N H Silverman |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: The American journal of cardiology Volume: 85 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2000 May |
Date Detail:
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Created Date: 2000-07-14 Completed Date: 2000-07-14 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1230-3 Citation Subset: AIM; IM |
Affiliation:
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Division of Pediatric Cardiology, University of Münster Medical School, Germany. tkohl@muenster.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aortic Valve
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abnormalities*,
ultrasonography Aortic Valve Stenosis / therapy*, ultrasonography Balloon Dilatation / methods* Fetal Death Fetus / surgery* Gestational Age Humans Infant Mortality Infant, Newborn Retrospective Studies Treatment Failure Ultrasonography, Prenatal |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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