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Foetal aortic valvuloplasty: experience of five cases

Published online by Cambridge University Press:  12 February 2013

Pablo Marantz ,
Horacio Aiello ,
Sofía Grinenco ,
Gustavo Izbizky ,
Gabriela Peña ,
Luis Trentacoste ,
Miguel Granja  and
Lucas Otaño
Pablo Marantz
Affiliation:
Fetal Medicine Unit, Hospital Italiano de Buenos Aires, Acassuso, Buenos Aires, Argentina Department of Pediatric Cardiology, Hospital Italiano de Buenos Aires, Acassuso, Buenos Aires, Argentina
Horacio Aiello
Affiliation:
Fetal Medicine Unit, Hospital Italiano de Buenos Aires, Acassuso, Buenos Aires, Argentina Department of Obstetrics and Gynecology, Hospital Italiano de Buenos Aires, Acassuso, Buenos Aires, Argentina
Sofía Grinenco*
Affiliation:
Fetal Medicine Unit, Hospital Italiano de Buenos Aires, Acassuso, Buenos Aires, Argentina Department of Pediatric Cardiology, Hospital Italiano de Buenos Aires, Acassuso, Buenos Aires, Argentina
Gustavo Izbizky
Affiliation:
Fetal Medicine Unit, Hospital Italiano de Buenos Aires, Acassuso, Buenos Aires, Argentina Department of Obstetrics and Gynecology, Hospital Italiano de Buenos Aires, Acassuso, Buenos Aires, Argentina
Gabriela Peña
Affiliation:
Department of Pediatric Cardiology, Hospital Italiano de Buenos Aires, Acassuso, Buenos Aires, Argentina
Luis Trentacoste
Affiliation:
Department of Pediatric Cardiology, Hospital Italiano de Buenos Aires, Acassuso, Buenos Aires, Argentina
Miguel Granja
Affiliation:
Department of Pediatric Cardiology, Hospital Italiano de Buenos Aires, Acassuso, Buenos Aires, Argentina
Lucas Otaño
Affiliation:
Fetal Medicine Unit, Hospital Italiano de Buenos Aires, Acassuso, Buenos Aires, Argentina Department of Obstetrics and Gynecology, Hospital Italiano de Buenos Aires, Acassuso, Buenos Aires, Argentina
*
Correspondence to: S. Grinenco, MD, Pediatric Cardiologist, Department of Pediatric Cardiology, Fetal Medicine Unit, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190 (C1181ACH), Buenos Aires, Argentina. Tel: +(5411) 4959-0200(8325); Fax: +(5411) 4959-0200(8325); E-mail: sofia.grinenco@hospitalitaliano.org.ar
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Abstract

Objectives

Foetal aortic valvuloplasty has been proposed as a strategy to improve left heart growth and function in foetuses with severe aortic stenosis at risk of progression to hypoplastic left heart syndrome. We report our experience with this intervention.

Methods and results

Between 2005 and 2010, five foetuses with aortic stenosis and at risk of progression to hypoplastic left heart syndrome underwent ultrasound-guided percutaneous foetal aortic valvuloplasty. There were no associated maternal complications or foetal demise. In one case, the pregnancy was terminated a couple of weeks after the intervention, one foetus evolved to hypoplastic left heart syndrome, and three did not.

Conclusions

Foetal aortic valvuloplasty seems to be a safe and feasible procedure. It has been reported that it has the potential to prevent progression to hypoplastic left heart syndrome in selected foetuses with severe aortic stenosis. Further investigation regarding physiological and clinical aspects of this disease both prenatally and postnatally will probably allow to improve therapeutic strategies and clinical outcome.

Keywords

Balloon valvuloplastyaortic valve stenosishypoplastic left heart syndromefoetal ultrasonographyheart defectscongenitalfoetal heart
Type
Original Articles
Information
Cardiology in the Young , Volume 23 , Issue 5 , October 2013 , pp. 675 - 681
Copyright
Copyright © Cambridge University Press 2013 

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