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Foetal therapy: what works? Closed interatrial septum

Published online by Cambridge University Press:  27 August 2014

Ulrike Herberg ,
Christoph Berg ,
Annegret Geipel ,
Ulrich Gembruch  and
Johannes Breuer
Ulrike Herberg*
Affiliation:
Department of Pediatric Cardiology, University of Bonn, Bonn, Germany
Christoph Berg
Affiliation:
Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany Department of Obstetrics and Prenatal Medicine, University of Cologne, Bonn, Germany
Annegret Geipel
Affiliation:
Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
Ulrich Gembruch
Affiliation:
Department of Obstetrics and Prenatal Medicine, University of Bonn, Bonn, Germany
Johannes Breuer
Affiliation:
Department of Pediatric Cardiology, University of Bonn, Bonn, Germany
*
Correspondence to: Dr U. Herberg, Department of Pediatric Cardiology, University of Bonn, Adenauerallee 119, 53113 Bonn, Germany. Tel: +49 228 287 33350; Fax: +49 228 287 33360; E-mail: [email protected]
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Abstract

Hypoplastic left-heart syndrome and critical aortic stenosis with severely restricted or intact foramen ovale are associated with high neonatal mortality and poor long-term outcome. Despite accurate foetal diagnosis and successful postnatal catheter-based and surgical intervention, the 1-month survival rate is about 33%. Changes in pulmonary vascular architecture resulting in pulmonary hypertension result in important long-term morbidity. Prenatal relief of left atrial and pulmonary hypertension may promote normal pulmonary vascular and parenchymal development and improve short- and long-term outcomes. Foetal atrial balloon septostomy, laser perforation, and stenting of the foetal interatrial septum are the current options for foetal therapy. This paper provides an overview of foetal diagnosis, selection of patients for foetal intervention, and interventional techniques, and also reviews the current status of foetal and postnatal outcomes after intrauterine intervention.

Keywords

Hypoplastic left-heart syndromecritical aortic stenosisrestrictive foramen ovalefoetal atrial septostomyfoetal atrial stent placement
Type
Original Article
Information
Cardiology in the Young , Volume 24 , Issue S2: Fetal cardiovascular medicine: current perspectives and future hopes , October 2014 , pp. 47 - 54
Copyright
© Cambridge University Press 2014 

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