Abstract:

Objective To explore the feasibility and short-term efficacy of fetal cardiac intervention (FCI) for critical congenital heart disease. Methods The clinical data of all the fetuses who underwent FCI in the intrauterine diagnosis and treatment center from August 2018 to May 2022 were included, including basic information from perinatal to postnatal, FCI surgical information, fetal echocardiogram information, etc., and the fetuses were followed up until 3 months after birth to analyze the feasibility, effectiveness and safety of FCI technology. Results Seven fetuses were included, 5 of whom underwent FCI surgery with a 100% success rate (5/5), including 2 cases of critical aortic stenosis (CAS) and 3 cases of pulmonary atresia with intact ventricular septum (PA/IVS). The median gestational age at the time of FCI surgery was 29⁺²(28⁺⁶-32⁺⁴) weeks. The echocardiographic indexes of 5 fetuses after FCI were significantly improved. All five fetuses were full-term, with a median gestational age of 39⁺²(38-39⁺⁴) weeks. After birth, aortic valvuloplasty was performed in 2 patients with CAS and percutaneous balloon dilatation of pulmonary valve was performed in 3 patients with PA/IVS. One case of CAS with cardiac insufficiency died in the neonatal period, and the other 4 cases had good prognosis during follow-up. Conclusion FCI is a safe and effective technique that is expected to improve the prognosis of critical congenital heart disease.

Key words: fetal cardiac intervention, aortic stenosis, pulmonary atresia with intact ventricular septum, congenital heart disease