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Study Examines Effects of In Utero Heart Procedure

Last Updated: September 29, 2009.

Successful fetal aortic valvuloplasty may lead to better growth of the aortic and mitral valves and the ascending aorta without change in left ventricular growth rate, according to research published online Sept. 28 in Circulation.

TUESDAY, Sept. 29 (HealthDay News) -- Successful fetal aortic valvuloplasty may lead to better growth of the aortic and mitral valves and the ascending aorta without change in left ventricular growth rate, according to research published online Sept. 28 in Circulation.

Doff B. McElhinney, M.D., of the Children's Hospital Boston, and colleagues analyzed data from 70 fetuses that underwent attempted aortic valvuloplasty during an eight-year period for aortic stenosis with evolving hypoplastic left heart syndrome.

The researchers found that the intervention was deemed technically successful in 52 fetuses. Successful intervention was associated with improved prenatal growth of the aortic and mitral valves, but not the left ventricle. Seventeen patients had biventricular outcomes. Factors at the intervention associated with biventricular outcome were larger left heart structures and greater left ventricular pressure.

"Fetal intervention for aortic stenosis with evolving hypoplastic left heart syndrome is generally not a standalone procedure that is either effective or ineffective. Rather, it is one element of a broader collaborative strategy for left heart salvage. We are still coming to understand the unique physiological characteristics of newborns who have undergone successful prenatal intervention and will no doubt need to modify our practice and strategy as we learn more. The potential benefits of fetal intervention must be weighed against the risks of technical failure, fetal demise, aortic regurgitation, and potential long-term adverse events that have yet to be identified," the authors conclude.

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