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Fetal intervention for critical aortic stenosis: advances, research and postnatal follow-up

Marantz, Pablo; Grinenco, Sofía

Current Opinion in Cardiology: January 2015 - Volume 30 - Issue 1 - p 89–94
doi: 10.1097/HCO.0000000000000128
PEDIATRICS: Edited by James C. Huhta
Editor's Choice

Purpose of review Fetal aortic valvuloplasty is intended to alter the natural history of aortic stenosis evolving to hypoplastic left heart syndrome. The most recently reported data and advances on this procedure were reviewed.

Recent findings The highlights of the latest experience are the advances in further understanding of the prenatal and postnatal natural history of this disease, and the way in which fetal aortic valvuloplasty impacts on it, the identification of new predictors of biventricular outcome, and the report of postnatal survival of intervened patients. Recently reported short-term and middle-term results are encouraging. Experimental research on procedural aspects is ongoing, with no definite results. Multicenter studies are also ongoing.

Summary In recent years, there have been advances in the understanding of the prenatal and postnatal process of aortic stenosis evolving to hypoplastic left heart syndrome and the effects of fetal aortic valvuloplasty, as well as the need of adequate postnatal therapeutic strategies for these patients. Procedural aspects are being studied with animal models, but still need far more experience before human application. Long-term results are still to be discovered, and multicenter studies may provide a new perspective. Continuing research is mandatory so that ultimately fetal heart intervention finds its place among the therapeutic resources for congenital heart disease.

Pediatric Cardiology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

Correspondence to Pablo Marantz, Hospital Italiano de Buenos Aires, Juan D. Perón 4190 (C1199ABD), Buenos Aires, Argentina. Tel: +54 911 4435 5094; e-mail: pablo.marantz@hospitalitaliano.org.ar

© 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins