Challenges and controversies in fetal diagnosis and treatment: hypoplastic left heart syndrome

Clin Perinatol. 2014 Dec;41(4):787-98. doi: 10.1016/j.clp.2014.08.004. Epub 2014 Oct 7.

Abstract

Today, almost 70% of babies with hypoplastic left heart syndrome (HLHS) will survive into adulthood, although significant long-term morbidity and mortality still exists. Prenatal diagnosis of HLHS is increasingly common, allowing improved counseling, and the potential for fetal intervention if indicated. Exciting progress continues to be made in the area of fetal diagnosis and intervention, specifically catheter intervention for intact atrial septum or severe aortic stenosis. Pediatric cardiologists should be keenly aware of the flaws of staged palliation for the treatment of HLHS, and need to keep abreast of the emerging data regarding fetal diagnosis and intervention.

Keywords: Fetal aortic valvuloplasty; Fetal echocardiography; Hypoplastic left heart syndrome; Maternal hyperoxygenation; Norwood operation.

Publication types

  • Review

MeSH terms

  • Aortic Valve / surgery*
  • Balloon Valvuloplasty*
  • Echocardiography
  • Female
  • Fetal Heart / diagnostic imaging*
  • Fetal Therapies*
  • Humans
  • Hypoplastic Left Heart Syndrome / diagnostic imaging
  • Hypoplastic Left Heart Syndrome / surgery*
  • Infant, Newborn
  • Norwood Procedures*
  • Pregnancy
  • Prognosis
  • Ultrasonography, Prenatal