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Literature on Fetal Therapy After Pulmonary Valvuloplasty

  • Roland GitterEmail author
  • Gerald Tulzer
Chapter

Abstract

Due to the relative rarity of the lesion and the complexity of patient selection and the intervention itself, current numbers of reported cases are limited to approximately two dozens. The first publication worldwide was issued in 2002 by Tulzer et al. [1] from Children’s Heart Center Linz, describing a successful valvulotomy of the pulmonary valve, performed in a fetus with heart failure at 28 weeks of gestation. Following the procedure significant growth of the tricuspid valve and the right ventricle was observed. The neonate was delivered at 38 weeks with a RV suitable for biventricular repair leading the authors to the conclusion that in utero pulmonary valvulotomy is feasible and may change the natural history of the condition in affected fetuses with PA/IVS [1]. In 2006 another successful intervention was reported by Galindo et al. [2] performed in a fetus with critical PS-IVS and heart failure at 25 weeks of gestation. After the procedure a significant improvement in fetal hemodynamics was seen up to 34 weeks, when a significant restenosis with signs of circulatory failure leads to premature delivery of the baby and an immediate postnatal valvuloplasty provided a biventricular repair for the baby [2].

References

  1. 1.
    Tulzer G, Arzt W, Franklin RCG, Loughna PV, Mair R, Gar- diner HM. Fetal pulmonary valvuloplasty for critical pulmonary stenosis/atresia with intact septum. Lancet. 2002;360(9345):1567–8.CrossRefPubMedGoogle Scholar
  2. 2.
    Galindo A, Gutierrez-Larraya F, Velasco JM, de la Fuente P. Pulmonary balloon valvuloplasty in a fetus with critical pulmonary stenosis/atresia with intact ventricular septum and heart failure. Fetal Diagn Ther. 2006;21:100–4.CrossRefPubMedGoogle Scholar
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    Tworetzky W, McElhinney DB, Marx GR, et al. In utero valvuloplasty for pulmonary atresia with hypoplastic right ventricle: techniques and outcomes. Pediatrics. 2009;124(3):e510–8.CrossRefPubMedPubMedCentralGoogle Scholar
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    Polat T, Danısman N. Pulmonary valvulotomy in a fetus with pulmonary atresia with intact ventricular septum: first experience in Turkey. Images Paediatr Cardiol. 2012;14(3):6–11.PubMedPubMedCentralGoogle Scholar
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    Gómez Montes E, Herraiz I, Mendoza A, Galindo A. Fetal intervention in right outflow tract obstructive disease: selection of candidates and results. Cardiol Res Pract. 2012;2012:592403.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Pediatric CardiologyChildren’s Heart Center Linz, Kepler University Hospital LinzLinzAustria

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