Fetal aortic valvuloplasty: first report of two cases from Saudi Arabia
Abstract Background Fetal aortic stenosis may progress to hypoplastic left heart syndrome (HLHS), which carries a poor prognosis. We report two infants with fetal aortic stenosis successfully treated with fetal aortic valvuloplasty (FAV) using balloon dilatation. Case presentation Of five fetuses wi...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13019-020-01195-y |
| _version_ | 1819150361059917824 |
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| author | Merna Atiyah Ahmed Kurdi Osama Al Tuwaijry Atif Al Sahari Maha Al Rakaf Inas Babic Fahad Al Habshan Zohair Alhalees Khalid Al Najashi |
| author_facet | Merna Atiyah Ahmed Kurdi Osama Al Tuwaijry Atif Al Sahari Maha Al Rakaf Inas Babic Fahad Al Habshan Zohair Alhalees Khalid Al Najashi |
| author_sort | Merna Atiyah |
| collection | DOAJ |
| description | Abstract Background Fetal aortic stenosis may progress to hypoplastic left heart syndrome (HLHS), which carries a poor prognosis. We report two infants with fetal aortic stenosis successfully treated with fetal aortic valvuloplasty (FAV) using balloon dilatation. Case presentation Of five fetuses with aortic stenosis fulfilling the FAV criteria of severe aortic stenosis with a left ventricular length Z-score of ≥ − 2, retrograde flow in the transverse aortic arch, left-to-right flow across the foramen ovale, monophasic mitral inflow, and significant left ventricular dysfunction, we obtained permission for FAV in two fetuses. FAV was performed successfully under echocardiographic guidance using balloon dilatation. Both fetuses survived to birth. During FAV, mild pericardial effusion developed when introducing the stylet needle in the second fetus, and this resolved within 48 h. No intraprocedural complications occurred in the first patient, and no maternal complications occurred. The first infant underwent the Ross procedure after birth and is currently 7 years old and doing well. The second patient underwent aortic and mitral valve repair with endocardial fibroelastosis resection approximately 2 weeks after birth, which temporarily addressed the mitral valve stenosis; high doses of inotropes were subsequently required. The infant died of sepsis at 2 months of age. Conclusion FAV using balloon dilatation to treat fetal aortic stenosis was successful in our two patients, with subsequent neonatal biventricular repair resulting in long-term survival in one patient and death secondary to sepsis in the second patient. |
| first_indexed | 2024-12-22T14:16:17Z |
| format | Article |
| id | doaj.art-76903bbf7d6e4d2585747d77de5787ca |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-12-22T14:16:17Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-76903bbf7d6e4d2585747d77de5787ca2022-12-21T18:23:05ZengBMCJournal of Cardiothoracic Surgery1749-80902020-06-011511610.1186/s13019-020-01195-yFetal aortic valvuloplasty: first report of two cases from Saudi ArabiaMerna Atiyah0Ahmed Kurdi1Osama Al Tuwaijry2Atif Al Sahari3Maha Al Rakaf4Inas Babic5Fahad Al Habshan6Zohair Alhalees7Khalid Al Najashi8Pediatric Cardiology Department, Prince Sultan Cardiac Center, Prince Sultan Military Medical CityObstetrics & Gynecology Department, Prince Sultan Military Medical CityObstetrics & Gynecology Department, Prince Sultan Military Medical CityPediatric Cardiology Department, Prince Sultan Cardiac Center, Prince Sultan Military Medical CityObstetrics & Gynecology Department, Prince Sultan Military Medical CityObstetrics & Gynecology Department, Prince Sultan Military Medical CityKing Abdul-Aziz Cardiac Center, National Guard HospitalDepartment of Cardiac Surgery, King Faisal Specialist Hospital & Research CenterPediatric Cardiology Department, Prince Sultan Cardiac Center, Prince Sultan Military Medical CityAbstract Background Fetal aortic stenosis may progress to hypoplastic left heart syndrome (HLHS), which carries a poor prognosis. We report two infants with fetal aortic stenosis successfully treated with fetal aortic valvuloplasty (FAV) using balloon dilatation. Case presentation Of five fetuses with aortic stenosis fulfilling the FAV criteria of severe aortic stenosis with a left ventricular length Z-score of ≥ − 2, retrograde flow in the transverse aortic arch, left-to-right flow across the foramen ovale, monophasic mitral inflow, and significant left ventricular dysfunction, we obtained permission for FAV in two fetuses. FAV was performed successfully under echocardiographic guidance using balloon dilatation. Both fetuses survived to birth. During FAV, mild pericardial effusion developed when introducing the stylet needle in the second fetus, and this resolved within 48 h. No intraprocedural complications occurred in the first patient, and no maternal complications occurred. The first infant underwent the Ross procedure after birth and is currently 7 years old and doing well. The second patient underwent aortic and mitral valve repair with endocardial fibroelastosis resection approximately 2 weeks after birth, which temporarily addressed the mitral valve stenosis; high doses of inotropes were subsequently required. The infant died of sepsis at 2 months of age. Conclusion FAV using balloon dilatation to treat fetal aortic stenosis was successful in our two patients, with subsequent neonatal biventricular repair resulting in long-term survival in one patient and death secondary to sepsis in the second patient.http://link.springer.com/article/10.1186/s13019-020-01195-yAortic valve stenosisFetal aortic ValvuloplastyFetal echocardiography |
| spellingShingle | Merna Atiyah Ahmed Kurdi Osama Al Tuwaijry Atif Al Sahari Maha Al Rakaf Inas Babic Fahad Al Habshan Zohair Alhalees Khalid Al Najashi Fetal aortic valvuloplasty: first report of two cases from Saudi Arabia Journal of Cardiothoracic Surgery Aortic valve stenosis Fetal aortic Valvuloplasty Fetal echocardiography |
| title | Fetal aortic valvuloplasty: first report of two cases from Saudi Arabia |
| title_full | Fetal aortic valvuloplasty: first report of two cases from Saudi Arabia |
| title_fullStr | Fetal aortic valvuloplasty: first report of two cases from Saudi Arabia |
| title_full_unstemmed | Fetal aortic valvuloplasty: first report of two cases from Saudi Arabia |
| title_short | Fetal aortic valvuloplasty: first report of two cases from Saudi Arabia |
| title_sort | fetal aortic valvuloplasty first report of two cases from saudi arabia |
| topic | Aortic valve stenosis Fetal aortic Valvuloplasty Fetal echocardiography |
| url | http://link.springer.com/article/10.1186/s13019-020-01195-y |
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