Skip to main content

Fetal Aortic Valvuloplasty: State of the Art

  • Chapter
  • First Online:
Fetal and Hybrid Procedures in Congenital Heart Diseases

Abstract

The most commonly performed fetal cardiac intervention (FCI) is aortic balloon valvuloplasty. The primary aim of fetal aortic valvuloplasty is to modify the in utero natural history of severe aortic stenosis, characterized by left heart growth arrest, and prevent progression to hypoplastic left heart syndrome (HLHS).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Makikallio K, McElhinney DB, Levine JC, Marx GR, Colan SD, Marshall AC, Lock JE, Marcus EN, Tworetzky W. Fetal aortic valve stenosis and the evolution of hypoplastic left heart syndrome: patient selection for fetal intervention. Circulation. 2006;113:1401–5.

    Article  PubMed  Google Scholar 

  2. Gurtner GC, Werner S, Barrandon Y, Longaker MT. Wound repair and regeneration. Nature. 2008;453(7193):314–21.

    Article  CAS  PubMed  Google Scholar 

  3. Wilkins-Haug LE, Benson CB, Tworetzky W, Marshall AC, Jennings RW, Lock JE. In-utero intervention for hypoplastic left heart syndrome – a Perinatologist’s perspective. Ultrasound Obstet Gynecol. 2005;26:481–6.

    Article  CAS  PubMed  Google Scholar 

  4. Limperopoulos C, Tworetzky W, McElhinney D, Newburger J, Brown D, Robertson Jr R, Guizard N, McGrath E, Geva J, Annese D, Dunbar-Masterson C, Trainor B, Laussen P, du Plessis A. Brain volume and metabolism in fetuses with congenital heart disease: evaluation with quantitative magnetic resonance imaging and spectroscopy. Circulation. 2010;121:26–33.

    Article  CAS  PubMed  Google Scholar 

  5. Maxwell D, Allan L, Tynan MJ. Balloon dilation of the aortic valve in the fetus: a report of two cases. Br Heart J. 1991;65:256–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Kohl T, Sharland G, Allan LD, Gembruch U, Chaoui R, Lopes LM, Zielinsky P, Huhta J, Silverman NH. World experience of percutaneous ultrasound-guided balloon valvuloplasty in human fetuses with severe aortic valve obstruction. Am J Cardiol. 2000;85:1230–3.

    Article  CAS  PubMed  Google Scholar 

  7. Tworetzky W, Wilkins-Haug L, Jennings RW, van der Velde ME, Marshall AC, Marx GR, Colan SD, Benson CB, Lock JE, Perry SB. Balloon dilation of severe aortic stenosis in the fetus: potential for prevention of hypoplastic left heart syndrome: candidate selection, technique, and results of successful intervention. Circulation. 2004;110(15):2125–31.

    Article  PubMed  Google Scholar 

  8. McElhinney DB, Marshall AC, Wilkins-Haug LE, Brown DW, Benson CB, Silva V. Predictors of technical success and postnatal biventricular outcome after in utero aortic valvuloplasty for aortic stenosis with evolving hypoplastic left heart syndrome. Circulation. 2009;120(15):1482–90.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Arzt W, Wertaschnigg D, Veit I, Klement F, Gitter R, Tulzer G. Intrauterine aortic valvuloplasty in fetuses with critical aortic stenosis: experience and results of 24 procedures. Ultrasound Obstet Gynecol. 2011;37(6):689–95.

    Article  CAS  PubMed  Google Scholar 

  10. Freud LR, McElhinney DB, Marshall AC, Marx GR, Friedman KG, del Nido PJ, et al. Fetal aortic valvuloplasty for evolving hypoplastic left heart syndrome: postnatal outcomes of the first 100 patients. Circulation. 2014;130(8):638–45.

    Article  PubMed  PubMed Central  Google Scholar 

  11. McElhinney DB, Vogel M, Benson CB, Marshall AC, Wilkins-Haug LE, Silva V. Assessment of left ventricular endocardial fibroelastosis in fetuses with aortic stenosis and evolving hypoplastic left heart syndrome. Am J Cardiol. 2010;106(12):1792–7.

    Article  PubMed  Google Scholar 

  12. Moon-Grady AJ, Morris SA, Belfort M, Chmait R, Dangel J, Devlieger R, Emery S, Frommelt M, Galindo A, Gelehrter S, Gembruch U, Grinenco S, Habli M, Herberg U, Jaeggi E, Kilby M, Kontopoulos E, Marantz P, Miller O, Otaño L, Pedra C, Pedra S, Pruetz J, Quintero R, Ryan G, Sharland G, Simpson J, Vlastos E, Tworetzky W, Wilkins-Haug L, Oepkes D. International Fetal Cardiac Intervention Registry: a Worldwide Collaborative Description and Preliminary Outcomes. J Am Coll Cardiol. 2015;66(4):388–99.

    Article  PubMed  Google Scholar 

  13. Emani SM, Bacha EA, McElhinney DB, Marx GR, Tworetzky W, Pigula FA. Primary left ventricular rehabilitation is effective in maintaining two-ventricle physiology in the borderline left heart. J Thorac Cardiovasc Surg. 2009;138(6):1276–82.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Marshall AC, Levine J, Morash D, et al. Results of in utero atrial septoplasty in fetuses with hypoplastic left heart syndrome. Prenat Diagn. 2008;28(11):1023–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francesca R. Pluchinotta MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Pluchinotta, F.R., Tworetzky, W. (2016). Fetal Aortic Valvuloplasty: State of the Art. In: Butera, G., Cheatham, J., Pedra, C., Schranz, D., Tulzer, G. (eds) Fetal and Hybrid Procedures in Congenital Heart Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-40088-4_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-40088-4_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-40086-0

  • Online ISBN: 978-3-319-40088-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics