Pulmonary Valvuloplasty: Fetal, Neonatal, and Follow-Up Outcomes

Abstract

The primary management and outcome of unborn children with atresia (PA/IVS) or critical stenosis of the pulmonary valve (CPS) and intact ventricular septum are still under discussion. The degree of the morphological and clinical picture of this disease can vary from a hypoplastic right heart syndrome with a univentricular physiology to a biventricular heart only with the need for valvuloplasty after delivery. Neonates with CPS or PA/IVS show considerable variation of abnormalities of the right ventricle, tricuspid valve (TV), and coronary arteries. Therefore, there is a wide range in the reported 5-year survival rate from 50 to 86% [1]. This cardiac malformation is rarely associated with chromosomal defects or extra-cardiac malformations. Therefore, the cardiologist’s prediction of a univentricular or biventricular circulation could have even more influence on the parents’ choice regarding the future of the pregnancy [2]. The focus of this chapter lies especially on the fetal and neonatal outcome of fetuses, who underwent pulmonary valvuloplasty in utero.