Key result
Fetal cardiac intervention for critical aortic stenosis with severe mitral regurgitation and restrictive foramen ovale resulted in 5 procedure-related deaths among 14 treated fetuses, with 4 survivors.
Why the study?
The intrauterine course and outcome of fetal cardiac intervention in fetuses with critical aortic stenosis, severe mitral regurgitation, severe left atrial dilatation, and restrictive foramen ovale or intact atrial septum had not been fully assessed.
Does fetal cardiac intervention improve survival and postnatal outcomes in fetuses with critical aortic stenosis, severe mitral regurgitation, severe left atrial dilatation, and restrictive foramen ovale?
Comparison
Fetal cardiac intervention vs expectative management or termination
Design
Single-center retrospective study
Authors
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High procedure-related mortality warrants extreme caution before offering fetal intervention; leaves open whether any survival benefit exists in this phenotype.
Cohort (n=19)
No
Does fetal cardiac intervention improve survival and postnatal outcomes in fetuses with critical aortic stenosis, severe mitral regurgitation, severe left atrial dilatation, and restrictive foramen ovale?
Fetal cardiac intervention in fetuses with critical aortic stenosis and severe associated defects carries a high mortality, with only a minority surviving to receive single ventricle palliation.
Mallmann et al. (2019) conducted a cohort in Critical aortic stenosis with severe mitral regurgitation, severe left atrial enlargement, and restrictive foramen ovale (n=19). Fetal cardiac intervention vs. Expectative management or termination was evaluated on Intrauterine course and postnatal outcome. Fetal cardiac intervention for critical aortic stenosis with severe mitral regurgitation and restrictive foramen ovale resulted in 5 procedure-related deaths among 14 treated fetuses, with 4 survivors.
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