Abstract 16469: Outcomes After In-Utero Cardiac Interventions: A Preliminary Report of the Collaborative International Fetal Cardiac Intervention Registry
Objective: Fetal cardiac intervention (FCI) for relief of semilunar valve stenosis or atrial level restriction has been reported in single-institution series promoting technical and physiologic success. No contemporary multi-center experience with FCI has been published. We describe creation of an international registry of cases presenting for possible FCI with the intention of compiling technical aspects and outcomes data.
Methods: The International Fetal Cardiac Intervention Registry (IFCIR) was established in 2010 to collect voluntarily submitted procedure-related data. For this initial descriptive analysis the database was queried for all entries, details of diagnosis, procedures performed, and outcomes. Maternal-fetal dyads referred since 2001 for possible FCI were included; a favorable outcome was defined as biventricular circulation for valvuloplasty and survival to discharge for atrial septal procedures.
Results: Of 372 cases included, 246 underwent FCI: 100 from a previous single-center report were not included in the present analysis. Among liveborn infants diagnosed in utero with evolving hypoplastic left heart syndrome, biventricular circulation was present more often when FCI was attempted (51% (95%CI 38-64%) v 23% (4-42%) p=0.02), but when procedure-related losses (n=15) and fetal demise (3) were counted as treatment failures in this cohort, the difference was no longer significant (biventricular in 36% of FCI group v 21% in non-FCI, p=0.16). Survival in fetuses with reported atrial restriction was similar with or without FCI (15/28 v 5/10), though non-uniform criteria for this diagnosis were noted in the analysis of the data.
Conclusion: In this initial report, we describe the content of the IFCIR, and present postnatal data that suggest a potential benefit to fetal therapy and support proposals for additional work in this area. Analyses pertaining to specific diseases and patient, center, and procedural variables are ongoing.
- Congenital heart disease
- Congenital heart surgery
- Interventional cardiology
- Structural heart disease intervention
- Pediatric cardiology
Author Disclosures: A.J. Moon-Grady: None. M. Belfort: Expert Witness; Modest; testimony. Ownership Interest; Modest; Glenveigh Medical Stockholder. R. Chmait: None. J. Dangel: None. R. Devlieger: None. S. Emery: None. A. Galindo: None. U. Gembruch: None. S. Grinenco: None. M. Habli: None. U. Herberg: None. E. Jaeggi: None. M. Kilby: Research Grant; Significant; Wellcome Trust HICF. Expert Witness; Modest; testimony. P. Marantz: None. S. Morris: Other Research Support; Modest; NIH R21. L. Otaño: None. C. Pedra: Research Grant; Modest; Atrium (USA). Speakers Bureau; Modest; Medtronic (USA). Honoraria; Modest; St Jude (USA). Consultant/Advisory Board; Modest; Occlutech (Germany); Lifetech (China); Scitech (Brazil). S. Pedra: None. J. Pruetz: None. R. Quintero: None. G. Ryan: None. G. Sharland: None. J. Simpson: None. E. Vlastos: None. W. Tworetzky: None. L. Wilkins-Haug: None. D. Oepkes: None.
- © 2014 by American Heart Association, Inc.