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Chapter 8 - Fetal Cardiac Intervention

from Section 2

Published online by Cambridge University Press:  19 November 2021

Olutoyin A. Olutoye
Affiliation:
Baylor College of Medicine, Texas
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Summary

Fetal cardiac intervention provides fetuses with certain cardiac anomalies, a greater likelihood of biventricular circulation and/or treatment options after delivery. Anesthesia care for mothers undergoing fetal cardiac intervention has evolved over the years and more recently involves the use of neuraxial anesthesia with sedation. The maternal fetal anesthesiologist caring for the patient undergoing fetal cardiac intervention should be conversant with the diagnosis, pathophysiology, and planned intervention. This is important for appropriate anticipation and treatment of hemodynamic changes that may occur in the fetus immediately following intervention.

Type
Chapter
Information
Anesthesia for Maternal-Fetal Surgery
Concepts and Clinical Practice
, pp. 103 - 118
Publisher: Cambridge University Press
Print publication year: 2021

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References

Gardiner, HM, Kovacevic, A, Tulzer, G, et al. Natural history of 107 cases of fetal aortic stenosis from a European multicenter retrospective study. Ultrasound Obstet Gynecol. 2016;48(3):373381. doi: 10.1002/uog.15876 [doi].CrossRefGoogle ScholarPubMed
Moon-Grady, AJ, Morris, SA, Belfort, M, et al. International fetal cardiac intervention registry: A worldwide collaborative description and preliminary outcomes. J Am Coll Cardiol. 2015;66(4):388399. doi: 10.1016/j.jacc.2015.05.037 [doi].CrossRefGoogle ScholarPubMed
Freud, LR, McElhinney, DB, Marshall, AC, et al. Fetal aortic valvuloplasty for evolving hypoplastic left heart syndrome: Postnatal outcomes of the first 100 patients. Circulation. 2014;130(8):638645. doi: 10.1161/CIRCULATIONAHA.114.009032 [doi].CrossRefGoogle ScholarPubMed
Mallmann, MR, Herberg, U, Gottschalk, I, et al. Fetal cardiac intervention in critical aortic stenosis with severe mitral regurgitation, severe left atrial enlargement, and restrictive foramen ovale. Fetal Diagn Ther. 2020;47(5):440447. doi: 10.1159/000502840 [doi].CrossRefGoogle ScholarPubMed
Tulzer, A, Arzt, W, Gitter, R, et al. Immediate effects and outcome of in-utero pulmonary valvuloplasty in fetuses with pulmonary atresia with intact ventricular septum or critical pulmonary stenosis. Ultrasound Obstet Gynecol. 2018;52(2):230237. doi: 10.1002/uog.19047 [doi].CrossRefGoogle ScholarPubMed
Jantzen, DW, Moon-Grady, AJ, Morris, SA, et al. Hypoplastic left heart syndrome with intact or restrictive atrial septum: A report from the international fetal cardiac intervention registry. Circulation. 2017;136(14):13461349. doi: 10.1161/CIRCULATIONAHA.116.025873 [doi].CrossRefGoogle ScholarPubMed
Friedman, KG, Sleeper, LA, Freud, LR, et al. Improved technical success, postnatal outcome and refined predictors of outcome for fetal aortic valvuloplasty. Ultrasound Obstet Gynecol. 2018;52(2):212220. doi: 10.1002/uog.17530 [doi].CrossRefGoogle ScholarPubMed
Nugent, AW, Kowal, RC, Juraszek, AL, Ikemba, C, Magee, K. Model of magnetically guided fetal cardiac intervention: Potential to avoid direct cardiac puncture. J Matern Fetal Neonatal Med. 2013;26(18):17781781. doi: 10.3109/14767058.2013.818116 [doi].CrossRefGoogle ScholarPubMed
Bakker, MK, Bergman, JEH, Krikov, S, et al. Prenatal diagnosis and prevalence of critical congenital heart defects: An international retrospective cohort study. BMJ Open. 2019;9(7):e028139-2018–028139. doi: 10.1136/bmjopen-2018-028139 [doi].CrossRefGoogle Scholar
Lytzen, R, Vejlstrup, N, Bjerre, J, et al. Live-born major congenital heart disease in Denmark: Incidence, detection rate, and termination of pregnancy rate from 1996 to 2013. JAMA Cardiol. 2018;3(9):829837. doi: 10.1001/jamacardio.2018.2009 [doi].CrossRefGoogle ScholarPubMed
Idorn, L, Olsen, M, Jensen, AS, et al. Univentricular hearts in Denmark 1977 to 2009: Incidence and survival. Int J Cardiol. 2013;167(4):13111316. doi: 10.1016/j.ijcard.2012.03.182 [doi].CrossRefGoogle ScholarPubMed
Egbe, A, Uppu, S, Lee, S, Ho, D, Srivastava, S. Changing prevalence of severe congenital heart disease: A population-based study. Pediatr Cardiol. 2014;35(7):12321238. doi: 10.1007/s00246-014-0921-7 [doi].CrossRefGoogle ScholarPubMed
Donofrio, MT, Moon-Grady, AJ, Hornberger, LK, et al. Diagnosis and treatment of fetal cardiac disease: A scientific statement from the American Heart Association. Circulation. 2014;129(21):21832242. doi: 10.1161/01.cir.0000437597.44550.5d [doi].CrossRefGoogle ScholarPubMed
Kirk, JS, Riggs, TW, Comstock, CH, Lee, W, Yang, SS, Weinhouse, E. Prenatal screening for cardiac anomalies: The value of routine addition of the aortic root to the four-chamber view. Obstet Gynecol. 1994;84(3):427431.Google ScholarPubMed
Del Bianco, A, Russo, S, Lacerenza, N, et al. Four chamber view plus three-vessel and trachea view for a complete evaluation of the fetal heart during the second trimester. J Perinat Med. 2006;34(4):309312. doi: 10.1515/JPM.2006.059 [doi].CrossRefGoogle ScholarPubMed
Bahtiyar, MO, Dulay, AT, Weeks, BP, et al. Prevalence of congenital heart defects in monochorionic/diamniotic twin gestations: A systematic literature review. J Ultrasound Med. 2007;26(11):14911498. doi: 26/11/1491[pii].CrossRefGoogle ScholarPubMed
Lopriore, E, Bokenkamp, R, Rijlaarsdam, M, et al. Congenital heart disease in twin-to-twin transfusion syndrome treated with fetoscopic laser surgery. Congenit Heart Dis. 2007;2(1):3843. doi: 10.1111/j.1747-0803.2007.00070.x [doi].CrossRefGoogle ScholarPubMed
Stumpflen, I, Stumpflen, A, Wimmer, M, Bernaschek, G. Effect of detailed fetal echocardiography as part of routine prenatal ultrasonographic screening on detection of congenital heart disease. Lancet. 1996;348(9031):854857. doi: S0140-6736(96)04069-X [pii].CrossRefGoogle ScholarPubMed
Yagel, S, Weissman, A, Rotstein, Z, et al. Congenital heart defects: Natural course and in utero development. Circulation. 1997;96(2):550555. doi: 10.1161/01.cir.96.2.550 [doi].CrossRefGoogle ScholarPubMed
Rakha, S, El Marsafawy, H. Sensitivity, specificity, and accuracy of fetal echocardiography for high-risk pregnancies in a tertiary center in Egypt. Arch Pediatr. 2019;26(6):337341. doi: S0929-693X(19)30117-4 [pii].CrossRefGoogle Scholar
Pinheiro, DO, Varisco, BB, Silva, MBD, et al. Accuracy of prenatal diagnosis of congenital cardiac MalformationsAcuracia do diagnostico pre-natal de cardiopatias congenitas. Rev Bras Ginecol Obstet. 2019;41(1):1116. doi: 10.1055/s-0038-1676058 [doi].Google ScholarPubMed
Pasierb, MM, Penalver, JM, Vernon, MM, Arya, B. The role of regional prenatal cardiac screening for congenital heart disease: A single center experience. Congenit Heart Dis. 2018;13(4):571577. doi: 10.1111/chd.12611 [doi].CrossRefGoogle ScholarPubMed
Yu, D, Sui, L, Zhang, N. Performance of first-trimester fetal echocardiography in diagnosing fetal heart defects: Meta-analysis and systematic review. J Ultrasound Med. 2020;39(3):471480. doi: 10.1002/jum.15123 [doi].CrossRefGoogle ScholarPubMed
McBrien, A, Hornberger, LK. Early fetal echocardiography. Birth Defects Res. 2019;111(8):370379. doi: 10.1002/bdr2.1414 [doi].CrossRefGoogle ScholarPubMed
Rychik, J, Ayres, N, Cuneo, B, et al. American Society of Echocardiography guidelines and standards for performance of the fetal echocardiogram. J Am Soc Echocardiogr. 2004;17(7):803810. doi: 10.1016/j.echo.2004.04.011 [doi].CrossRefGoogle ScholarPubMed
Hornberger, LK, Sahn, DJ. Rhythm abnormalities of the fetus. Heart. 2007;93(10):12941300. doi: 93/10/1294[pii].CrossRefGoogle ScholarPubMed
Stewart, PA, Wladimiroff, JW. Fetal echocardiography and color doppler flow imaging: The Rotterdam experience. Ultrasound Obstet Gynecol. 1993;3(3):168175. doi: 10.1046/j.1469-0705.1993.03030168.x [doi].CrossRefGoogle ScholarPubMed
Copel, JA, Morotti, R, Hobbins, JC, Kleinman, CS. The antenatal diagnosis of congenital heart disease using fetal echocardiography: Is color flow mapping necessary? Obstet Gynecol. 1991;78(1):18.Google ScholarPubMed
Gembruch, U, Chatterjee, MS, Bald, R, et al. Color doppler flow mapping of fetal heart. J Perinat Med. 1991;19(1–2):2732.CrossRefGoogle ScholarPubMed
Moon-Grady, A, Shahanavaz, S, Brook, M, et al. Can a complete fetal echocardiogram be performed at 12 to 16 weeks’ gestation? J Am Soc Echocardiogr. 2012;25(12):13421352. doi: 10.1016/j.echo.2012.09.003 [doi].CrossRefGoogle Scholar
Comas Gabriel, C, Galindo, A, Martinez, JM, et al. Early prenatal diagnosis of major cardiac anomalies in a high-risk population. Prenat Diagn. 2002;22(7):586593. doi: 10.1002/pd.372 [doi].CrossRefGoogle ScholarPubMed
Fouron, JC, Fournier, A, Proulx, F, et al. Management of fetal tachyarrhythmia based on superior vena cava/aorta doppler flow recordings. Heart. 2003;89(10):12111216. doi: 10.1136/heart.89.10.1211 [doi].CrossRefGoogle ScholarPubMed
Carvalho, JS, Prefumo, F, Ciardelli, V, et al. Evaluation of fetal arrhythmias from simultaneous pulsed wave doppler in pulmonary artery and vein. Heart. 2007;93(11):14481453. doi: hrt.2006.101659 [pii].CrossRefGoogle ScholarPubMed
Copel, JA, Pilu, G, Kleinman, CS. Congenital heart disease and extracardiac anomalies: Associations and indications for fetal echocardiography. Am J Obstet Gynecol. 1986;154(5):11211132. doi: 0002-9378(86)90773-8 [pii].CrossRefGoogle ScholarPubMed
Cai, M, Huang, H, Su, L, et al. Fetal congenital heart disease: Associated anomalies, identification of genetic anomalies by single-nucleotide polymorphism array analysis, and postnatal outcome. Medicine (Baltimore). 2018;97(50):e13617. doi: 10.1097/MD.0000000000013617 [doi].CrossRefGoogle ScholarPubMed
Sun, H, Yi, T, Hao, X, et al. Contribution of single-gene defects to congenital cardiac left-sided lesions in the prenatal setting. Ultrasound Obstet Gynecol. 2020;56(2):225232. doi: 10.1002/uog.21883 [doi].CrossRefGoogle ScholarPubMed
Lord, J, McMullan, DJ, Eberhardt, RY, et al. Prenatal exome sequencing analysis in fetal structural anomalies detected by ultrasonography (PAGE): A cohort study. Lancet. 2019;393(10173):747757. doi: S0140-6736(18)31940-8 [pii].CrossRefGoogle ScholarPubMed
Schidlow, DN, Freud, L, Friedman, K, Tworetzky, W. Fetal interventions for structural heart disease. Echocardiography. 2017;34(12):18341841. doi: 10.1111/echo.13667 [doi].CrossRefGoogle ScholarPubMed
Krishnan, A, Arya, B, Moak, JP, Donofrio, MT. Outcomes of fetal echocardiographic surveillance in anti-SSA exposed fetuses at a large fetal cardiology center. Prenat Diagn. 2014;34(12):12071212. doi: 10.1002/pd.4454 [doi].CrossRefGoogle Scholar
Co-Vu, J, Lopez-Colon, D, Vyas, HV, et al. Maternal hyperoxygenation: A potential therapy for congenital heart disease in the fetuses? A systematic review of the current literature. Echocardiography. 2017;34(12):18221833. doi: 10.1111/echo.13722 [doi].CrossRefGoogle ScholarPubMed
Cuneo, BF, Moon-Grady, AJ, Sonesson, SE, et al. Heart sounds at home: Feasibility of an ambulatory fetal heart rhythm surveillance program for anti-SSA-positive pregnancies. J Perinatol. 2017;37(3):226230. doi: 10.1038/jp.2016.220 [doi].CrossRefGoogle ScholarPubMed
Rychik, J, Khalek, N, Gaynor, JW, et al. Fetal intrapericardial teratoma: Natural history and management including successful in utero surgery. Am J Obstet Gynecol. 2016;215(6):780.e1-780.e7. doi: S0002-9378(16)30575-0 [pii].CrossRefGoogle ScholarPubMed
Riskin-Mashiah, S, Moise, KJ, Jr., Wilkins, I, et al. In utero diagnosis of intrapericardial teratoma: A case for in utero open fetal surgery. Prenat Diagn. 1998;18(12):13281330. doi: 10.1002/(SICI)1097-0223(199812)18:123.0.CO;2-7 [pii].3.0.CO;2-7>CrossRefGoogle ScholarPubMed
Edwards, LA, Lara, DA, Sanz Cortes, M, et al. Chronic maternal hyperoxygenation and effect on cerebral and placental vasoregulation and neurodevelopment in fetuses with left heart hypoplasia. Fetal Diagn Ther. 2019;46(1):4557. doi: 10.1159/000489123 [doi].CrossRefGoogle ScholarPubMed
Arunamata, A, Axelrod, DM, Bianco, K, et al. Chronic antepartum maternal hyperoxygenation in a case of severe fetal Ebstein’s anomaly with circular shunt physiology. Ann Pediatr Cardiol. 2017;10(3):284287. doi: 10.4103/apc.APC_20_17 [doi].CrossRefGoogle Scholar
Lara, DA, Morris, SA, Maskatia, SA, et al. Pilot study of chronic maternal hyperoxygenation and effect on aortic and mitral valve annular dimensions in fetuses with left heart hypoplasia. Ultrasound Obstet Gynecol. 2016;48(3):365372. doi: 10.1002/uog.15846 [doi].CrossRefGoogle ScholarPubMed
Zeng, S, Zhou, Q, Zhang, M, et al. Features and outcome of fetal cardiac aneurysms and diverticula: A single center experience in China. Prenat Diagn. 2016;36(1):6873. doi: 10.1002/pd.4714 [doi].CrossRefGoogle ScholarPubMed
Garcia Rodriguez, R, Rodriguez Guedes, A, Garcia Delgado, R, et al. Prenatal diagnosis of cardiac diverticulum with pericardial effusion in the first trimester of pregnancy with resolution after early pericardiocentesis. Case Rep Obstet Gynecol. 2015;2015:154690. doi: 10.1155/2015/154690 [doi].CrossRefGoogle Scholar
Carpenter, RJ, Jr., Strasburger, JF, Garson A, Jr., et al. Fetal ventricular pacing for hydrops secondary to complete atrioventricular block. J Am Coll Cardiol. 1986;8(6):14341436. doi: S0735-1097(86)80319-9 [pii].CrossRefGoogle ScholarPubMed
Zhou, L, Vest, AN, Chmait, RH, et al. A percutaneously implantable fetal pacemaker. Conf Proc IEEE Eng Med Biol Soc. 2014;2014:4459–4463. doi: 10.1109/EMBC.2014.6944614 [doi].CrossRefGoogle Scholar
Nassr, AA, Shazly, SA, Morris, SA, et al. Prenatal management of fetal intrapericardial teratoma: A systematic review. Prenat Diagn. 2017;37(9):849863. doi: 10.1002/pd.5113 [doi].CrossRefGoogle ScholarPubMed
Heerema-McKenney, A, Harrison, MR, Bratton, B, et al. Congenital teratoma: A clinicopathologic study of 22 fetal and neonatal tumors. Am J Surg Pathol. 2005;29(1):2938. doi: 00000478-200501000-00004 [pii].CrossRefGoogle ScholarPubMed
Gardiner, HM. In utero intervention for severe congenital heart disease. Best Pract Res Clin Obstet Gynaecol. 2019;58:4254. doi: S1521-6934(19)30003-3 [pii].CrossRefGoogle Scholar
Gellis, L, Tworetzky, W. The boundaries of fetal cardiac intervention: Expand or tighten? Semin Fetal Neonatal Med. 2017;22(6):399403. doi: S1744-165X(17)30095-1 [pii].CrossRefGoogle ScholarPubMed
Kovacevic, A, Ohman, A, Tulzer, G, et al. Fetal hemodynamic response to aortic valvuloplasty and postnatal outcome: A European multicenter study. Ultrasound Obstet Gynecol. 2018;52(2):221229. doi: 10.1002/uog.18913 [doi].CrossRefGoogle ScholarPubMed
Freud, LR, Moon-Grady, A, Escobar-Diaz, MC, et al. Low rate of prenatal diagnosis among neonates with critical aortic stenosis: Insight into the natural history in utero. Ultrasound Obstet Gynecol. 2015;45(3):326332. doi: 10.1002/uog.14667 [doi].CrossRefGoogle ScholarPubMed
Makikallio, K, McElhinney, DB, Levine, JC, et al. Fetal aortic valve stenosis and the evolution of hypoplastic left heart syndrome: Patient selection for fetal intervention. Circulation. 2006;113(11):14011405. doi: CIRCULATIONAHA.105.588194 [pii].CrossRefGoogle ScholarPubMed
Tworetzky, W, Wilkins-Haug, L, Jennings, RW, et al. 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):21252131. doi: 01.CIR.0000144357.29279.54 [pii].CrossRefGoogle ScholarPubMed
Rychik, J, Rome, JJ, Collins, MH, et al. The hypoplastic left heart syndrome with intact atrial septum: Atrial morphology, pulmonary vascular histopathology and outcome. J Am Coll Cardiol. 1999;34(2):554560. doi: S0735-1097(99)00225-9 [pii].CrossRefGoogle ScholarPubMed
Vlahos, AP, Lock, JE, McElhinney, DB, van der Velde, ME. Hypoplastic left heart syndrome with intact or highly restrictive atrial septum: Outcome after neonatal transcatheter atrial septostomy. Circulation. 2004;109(19):23262330. doi: 10.1161/01.CIR.0000128690.35860.C5 [doi].CrossRefGoogle ScholarPubMed
Goltz, D, Lunkenheimer, JM, Abedini, M, et al. Left ventricular obstruction with restrictive inter-atrial communication leads to retardation in fetal lung maturation. Prenat Diagn. 2015;35(5):463470. doi: 10.1002/pd.4559 [doi].CrossRefGoogle ScholarPubMed
Arai, S, Fujii, Y, Kotani, Y, et al. Surgical outcome of hypoplastic left heart syndrome with intact atrial septum. Asian Cardiovasc Thorac Ann. 2015;23(9):10341038. doi: 10.1177/0218492315606581 [doi].CrossRefGoogle ScholarPubMed
Bichell, D. Invited commentary. Ann Thorac Surg. 2020;109(3):833834. doi: S0003-4975(19)31550-4 [pii].CrossRefGoogle ScholarPubMed
Salve, GG, Datar, GM, Perumal, G, et al. Impact of high-risk characteristics in hypoplastic left heart syndrome. World J Pediatr Congenit Heart Surg. 2019;10(4):475484. doi: 10.1177/2150135119852319 [doi].CrossRefGoogle ScholarPubMed
Vida, VL, Bacha, EA, Larrazabal, A, et al. Hypoplastic left heart syndrome with intact or highly restrictive atrial septum: Surgical experience from a single center. Ann Thorac Surg. 2007;84(2):581585; discussion 586. doi: S0003-4975(07)00729-1 [pii].CrossRefGoogle ScholarPubMed
Glatz, JA, Tabbutt, S, Gaynor, JW, et al. Hypoplastic left heart syndrome with atrial level restriction in the era of prenatal diagnosis. Ann Thorac Surg. 2007;84(5):16331638. doi: S0003-4975(07)01367-7 [pii].CrossRefGoogle ScholarPubMed
Gellis, L, Drogosz, M, Lu, M, et al. Echocardiographic predictors of neonatal illness severity in fetuses with critical left heart obstruction with intact or restrictive atrial septum. Prenat Diagn. 2018;38(10):788794. doi: 10.1002/pd.5322 [doi].CrossRefGoogle ScholarPubMed
Divanovic, A, Hor, K, Cnota, J, et al. Prediction and perinatal management of severely restrictive atrial septum in fetuses with critical left heart obstruction: Clinical experience using pulmonary venous doppler analysis. J Thorac Cardiovasc Surg. 2011;141(4):988994. doi: 10.1016/j.jtcvs.2010.09.043 [doi].CrossRefGoogle ScholarPubMed
Chaturvedi, RR, Ryan, G, Seed, M, et al. Fetal stenting of the atrial septum: Technique and initial results in cardiac lesions with left atrial hypertension. Int J Cardiol. 2013;168(3):20292036. doi: 10.1016/j.ijcard.2013.01.173 [doi].CrossRefGoogle ScholarPubMed
Kalish, BT, Tworetzky, W, Benson, CB, et al. Technical challenges of atrial septal stent placement in fetuses with hypoplastic left heart syndrome and intact atrial septum. Catheter Cardiovasc Interv. 2014;84(1):7785. doi: 10.1002/ccd.25098 [doi].CrossRefGoogle ScholarPubMed
Rogers, LS, Peterson, AL, Gaynor, JW, et al. Mitral valve dysplasia syndrome: A unique form of left-sided heart disease. J Thorac Cardiovasc Surg. 2011;142(6):13811387. doi: 10.1016/j.jtcvs.2011.06.002 [doi].CrossRefGoogle ScholarPubMed
Vogel, M, McElhinney, DB, Wilkins-Haug, LE, et al. Aortic stenosis and severe mitral regurgitation in the fetus resulting in giant left atrium and hydrops: Pathophysiology, outcomes, and preliminary experience with pre-natal cardiac intervention. J Am Coll Cardiol. 2011;57(3):348355. doi: 10.1016/j.jacc.2010.08.636 [doi].CrossRefGoogle ScholarPubMed
Ide, T, Miyoshi, T, Kitano, M, et al. Fetal critical aortic stenosis with natural improvement of hydrops fetalis due to spontaneous relief of severe restrictive atrial communication. J Obstet Gynaecol Res. 2015;41(7):11371140. doi: 10.1111/jog.12681 [doi].CrossRefGoogle ScholarPubMed
Belfort, MA, Morris, SA, Espinoza, J, et al. Thulium laser-assisted atrial septal stent placement: First use in fetal hypoplastic left heart syndrome and intact atrial septum. Ultrasound Obstet Gynecol. 2019;53(3):417418. doi: 10.1002/uog.20161 [doi].CrossRefGoogle ScholarPubMed
Tulzer, G, Arzt, W, Franklin, RC, et al. Fetal pulmonary valvuloplasty for critical pulmonary stenosis or atresia with intact septum. Lancet. 2002;360(9345):15671568. doi: S0140-6736(02)11531-5 [pii].CrossRefGoogle ScholarPubMed
Gomez 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. doi: 10.1155/2012/592403 [doi].CrossRefGoogle Scholar
Polat, T, Danisman, N. Pulmonary valvulotomy in a fetus with pulmonary atresia with intact ventricular septum: First experience in Turkey. Images Paediatr Cardiol. 2012;14(3):611.Google Scholar
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. doi: 10.1542/peds.2008-2014 [doi].CrossRefGoogle ScholarPubMed
Roman, KS, Fouron, JC, Nii, M, et al. Determinants of outcome in fetal pulmonary valve stenosis or atresia with intact ventricular septum. Am J Cardiol. 2007;99(5):699703. doi: S0002-9149(06)02277-6 [pii].CrossRefGoogle ScholarPubMed
Gardiner, HM. In-utero intervention for severe congenital heart disease. Best Pract Res Clin Obstet Gynaecol. 2008;22(1):4961. doi: 10.1016/j.bpobgyn.2007.06.003.CrossRefGoogle ScholarPubMed
Gottschalk, I, Strizek, B, Menzel, T, et al. Severe pulmonary stenosis or atresia with intact ventricular septum in the fetus: The natural history. Fetal Diagn Ther. 2020;47(5):420428. doi: 10.1159/000502178 [doi].CrossRefGoogle ScholarPubMed
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):10231028. doi: 10.1002/pd.2114 [doi].CrossRefGoogle ScholarPubMed
Jaeggi, E, Renaud, C, Ryan, G, Chaturvedi, R. Intrauterine therapy for structural congenital heart disease: Contemporary results and Canadian experience. Trends Cardiovasc Med. 2016;26(7):639646. doi: 10.1016/j.tcm.2016.04.006 [doi].CrossRefGoogle ScholarPubMed
Ferschl, MB, Feiner, J, Vu, L, et al. A comparison of spinal anesthesia versus monitored anesthesia care with local anesthesia in minimally invasive fetal surgery. Anesth Analg. 2020;130(2):409415. doi: 10.1213/ANE.0000000000003947 [doi].CrossRefGoogle ScholarPubMed
McElhinney, DB, Marshall, AC, Wilkins-Haug, LE, et al. 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):14821490. doi: 10.1161/CIRCULATIONAHA.109.848994 [doi].CrossRefGoogle ScholarPubMed
Arzt, W, Wertaschnigg, D, Veit, I, et al. Intrauterine aortic valvuloplasty in fetuses with critical aortic stenosis: Experience and results of 24 procedures. Ultrasound Obstet Gynecol. 2011;37(6):689695. doi: 10.1002/uog.8927 [doi].CrossRefGoogle ScholarPubMed
Galindo, A, Gomez-Montes, E, Gomez, O, et al. Fetal aortic valvuloplasty: Experience and results of two tertiary centers in Spain. Fetal Diagn Ther. 2017;42(4):262270. doi: 10.1159/000460247 [doi].CrossRefGoogle ScholarPubMed

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