Fetal Cardiac Intervention for Pulmonary Atresia with Intact Ventricular Septum: International Fetal Cardiac Intervention Registry

• Tipo: Artigo em Revista Científica Internacional
• Data: 2020

Autores

Hogan, WJ (Autor) Outra; Grinenco, S (Autor) Outra; Armstrong, A (Autor) Outra; Devlieger, R (Autor) Outra; Dangel, J (Autor) Outra; Ferrer, Q (Autor) Outra; Frommelt, M (Autor) Outra; Galindo, A (Autor) Outra; Gardiner, H (Autor) Outra; Gelehrter, S (Autor) Outra; Herberg, U (Autor) Outra; Howley, L (Autor) Outra; Jaeggi, E (Autor) Outra; Joana Miranda (Autor) FMUP; Morris, SA (Autor) Outra; Oepkes, D (Autor) Outra; Pedra, S (Autor) Outra; Peterson, R (Autor) Outra; Sholler, G (Autor) Outra; Simpson, J (Autor) Outra; Strainic, J (Autor) Outra; Vigneswarran, TV (Autor) Outra; Wacker Gussmann, A (Autor) Outra; Moon Grady, AJ (Autor) Outra

Revista

Título: Fetal Diagnosis and Therapy

Vol. 47

Páginas: 731-739

ISSN: 1015-3837

Editora: Karger

Indexação

ISI Web of Knowledge - 5 Citações

Scopus - 9 Citações

Outras Informações

ID Authenticus: P-00S-HBC

DOI: 10.1159/000508045

Abstract (EN): Introduction:Invasive fetal cardiac intervention (FCI) for pulmonary atresia with intact ventricular septum (PAIVS) and critical pulmonary stenosis (PS) has been performed with small single-institution series reporting technical and physiological success. We present the first multicenter experience.Objectives:Describe fetal and maternal characteristics of those being evaluated for FCI, including pregnancy/neonatal outcome data using the International Fetal Cardiac Intervention Registry (IFCIR).Methods:We queried the IFCIR for PAIVS/PS cases evaluated from January 2001 to April 2018 and reviewed maternal/fetal characteristics, procedural details, pregnancy and neonatal outcomes. Data were analyzed using standard descriptive statistics.Results:Of the 84 maternal/fetal dyads in the registry, 58 underwent pulmonary valvuloplasty at a median gestational age of 26.1 (21.9-31.0) weeks. Characteristics of fetuses undergoing FCI varied in terms of tricuspid valve (TV) size, TV regurgitation, and pulmonary valve patency. There were fetal complications in 55% of cases, including 7 deaths and 2 delayed fetal losses. Among those who underwent successful FCI, the absolute measurement of the TV increased by 0.32 (+/- 0.17) mm/week from intervention to birth. Among 60 liveborn with known outcome, there was a higher percentage having a biventricular circulation following successful FCI (87 vs. 43%).Conclusions:Our data suggest a possible benefit to fetal therapy for PAIVS/PS, though rates of technically unsuccessful procedures and procedure-related complications, including fetal loss were substantial. FCI criteria are extremely variable, making direct comparison to nonintervention patients challenging and potentially biased. More uniform FCI criteria for fetuses with PAIVS/PS are needed to avoid unnecessary procedures, expose only fetuses most likely to sustain a benefit, and to enable comparisons to be made with nonintervention patients.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 9