Foetal/fetal surgery has occurred in a variety of disciplines, but mainly in general/abdominal surgery. Does anyone know of any researchers or research groups that are interested in cardiac surgery in utero?
Wayne Tworetzky, Audrey Marshall, Jim Lock and colleagues at Children's Hospital Boston have an active fetal cardiac intervention program which includes fetal aortic ballon valvuloplasty for critical aortic stenosis, atrial septum dilation/stenting for HLHS with intact atrial septum and pulmonary balloon valvuloplasty for PA/IVS.
Twenty years ago Shak Qureshi at Guy's in London performed a balloon valvuloplasty on 4 pregnants in order to dilate an aortic stenotic valve and promote the growth of the LV. Only one on four had a successful outcome. I really do not know further experiences on fetal treatment but i think there have been disappointing results; moreover with the improvement of the results of interventional cardiology in the neonatal period, the indications to fetal intervention are more and more limited. Even more 'clouds crowding the horizon of fetal heart surgery whose problems of placental dysfunction limit human attempts
As Mark implied the biggest group in N America is Wayne's in Boston, a few other centers have reasonable volumes of cases - Ann Arbor has a fetal cardiac program at Mott Children's. North of the border there have been one or two cases done and other centers are considering the options.
If you are looking for somewhere more local then Wolfgang Arzt in Linz (germany) is your best bet at present - Guy's as was mentioned with Drs Quereshi and Maxwell semi-pioneered this but in London attempts to correct AS, PS etc in-utero faded out soon after their first cases.
This is what i thought, I had read about 'pioneer' programs, but these all seem to end with fading out of the scheme, mainly due to poor outcomes coupled with the ethical and moral objections of other clinicians and lay people.
I knew there were a few different people/groups undertaking these projects a while ago, but thought a lot of them had closed their research program.
I am just concerned for the future of this form of surgery/intervention, as it may be on the decline from its already humble beginnings.
I'd refer you to Emani et al in JACC from ~2 months ago. The Boston cardiac fetal intervention program is coupled with a rather aggressive postnatal LV recruitment strategy for the neonate with a borderline LV/AS (42% in this series had undergone a fetal intervention). This fetal intervention program is still quite active.
- Badges
- Science topic
- Similar topics
- Psychology