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Congenital Heart Disease Treatments

What are my choices during this pregnancy?

Accurate prenatal diagnosis by an experienced fetal echocardiographer/cardiologist is essential. In most cases of congenital heart disease, the diagnosis is reassuring and postnatal management at an appropriate referral center will improve outcome. In most of these cases, the timing and type of delivery will not affect outcome, but the place of delivery will. These families will want to work out a plan for delivery and postnatal care with their obstetrician/perinatologist, pediatric cardiologist, and pediatric cardiac surgeon, so the baby can be stabilized and treated in the same center.

Fetuses with aortic or pulmonary stenosis and signs of developing hypoplastic (small) left or right heart syndrome (respectively) or heart failure before birth may be candidates for intervention. If hypoplastic left or right heart syndrome has already developed and the fetus is mature (beyond 30 weeks of gestation), planned delivery at a pediatric cardiac center may be the best choice.

For fetuses earlier in gestation who have not already developed severe damage to the ventricular wall with underdevelopment of the heart on the side of the obstruction, intervention to dilate or enlarge the obstructed valve may be considered. An obstructed outlet valve can be dilated using a balloon catheter placed into the fetal heart through the mother’s abdominal wall, using Fetal Image-Guided Surgery (FIGS-IT), or through the uterine wall after opening the mother’s abdomen. In some cases, these technically difficult procedures may require open fetal surgery. Only a few centers are developing these experimental techniques to correct fetal heart defects like aortic stenosis and pulmonary stenosis.

For more information please download our PDF Brochure about Fetal Intervention for Congenital Heart Disease