Fetal hemodynamic response to aortic valvuloplasty and postnatal outcome: a European multicenter study

What is it about?

Fetal aortic stenosis may progress to hypoplastic left heart syndrome. Fetal valvuloplasty (FV) has been proposed to improve left heart hemodynamics and maintain a biventricular circulation (BV). We compared survival and postnatal circulation between prenatally treated (FV) and an untreated,contemporaneously collected natural history (NH) cohorts in a retrospective, multicenter study using a propensity score model. We show that FV improves postnatal circulatory outcomes and survival after birth, and preserves left heart growth. However the FV procedure carries a 10% risk of fetal loss and appears to be associated with increased prematurity. We believe that FV case selection is key and we recommend integrated fetal and postnatal management strategies to optimize the benefits achieved by FV.

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