Literature on Fetal Therapy After Pulmonary Valvuloplasty
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.  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 . In 2006 another successful intervention was reported by Galindo et al.  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 .