Fetal cardiac interventions

ABSTRACT

In the last 15­20 years, fetal cardiac interventions have become an accepted therapeutic modality for some complex congenital heart diseases (CHD) in utero, including aortic stenosis (AS) and evolving hypoplastic left heart syndrome (HLHS), HLHS with intact or highly restrictive interatrial septum (IAS), and pulmonary atresia (PA) or critical pulmonary stenosis (CPS) with intact ventricular septum (IVS) and evolving hypoplastic right heart syndrome (HRHS). The purpose of a fetal cardiac intervention is to remodel cardiac morphology and function and improve pre- and postnatal outcomes. Increased survival rates, reduced morbidity, and increased likelihood of achieving a biventricular (BV) circulation may all result from a successful fetal cardiac intervention in some scenarios. The objective of this chapter is to give an overview of these procedures with emphasis on pictures to illustrate how they are performed in a step-to-step fashion. (AU)