The first experience with intrauterine balloon vulvoplasty in aortic stenosis
- Authors: Kurtser M.A.1,2,3, Malmberg O.L.2,3,4, Grigoryan A.M.2, Samsonova O.A.3,4, Mkrtychyan B.T.3, Shamanova M.B.3, Normantovich T.O.3, Mamaeva A.V.3, Latyshkevich O.A.5, Gaponenko E.A.3,4, Sysolyatina E.V.2
-
Affiliations:
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
- Lapino Clinical Hospital, “Mother and Child” Group of Companies
- MD GROUP Clinical Hospital, “Mother and Child” Group of Companies
- Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia
- Center for Family Planning and Reproduction, Moscow City Healthcare Department
- Issue: No 5 (2023)
- Pages: 153-158
- Section: Clinical Notes
- URL: https://journal-vniispk.ru/0300-9092/article/view/274557
- DOI: https://doi.org/10.18565/aig.2023.61
- ID: 274557
Cite item
Open Access
Access granted
Subscription Access
Abstract
Background: Outflow tract obstruction of the left ventricle (LV) is one of the causes of a disorder of its growth and development of hypoplastic left heart syndrome (HLHS). This pathological condition fails to support systemic blood flow and requires postnatal correction, by creating univentricular blood circulation, a palliative operation with a poor vital prognosis for the newborn. Intrauterine balloon vulvoplasty is a method of treatment that contributes to the improvement of LV growth, which in turn increases the likelihood of maintaining biventricular circulation after birth.
Case report: The paper describes the authors’ first experience with a cardiac intrauterine intervention in a fetus with critical aortic valve stenosis. It briefly outlines the medical history of a female patient, the time course of changes in ultrasound data, the compliance of ECHO-CG readings to the criteria of the International Fetal Cardiac Intervention Registry, describes the technique of balloon vulvoplasty and presents the early hemodynamic results after intrauterine correction.
Conclusion: The early hemodynamic changes after intrauterine intervention in the fetus with critical aortic valve stenosis confirmed the efficiency of balloon vulvoplasty in this pathology. A further follow-up of neonatal hemodynamic parameters after intrauterine cardiac defect correction is required to assess the long-term results of intrauterine correction.
Full Text
##article.viewOnOriginalSite##About the authors
Mark A. Kurtser
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; Lapino Clinical Hospital, “Mother and Child” Group of Companies; MD GROUP Clinical Hospital, “Mother and Child” Group of Companies
Author for correspondence.
Email: malmberg.olga@gmail.com
Academician of the Russian Academy of Sciences, Head of the Department of Obstetrics and Gynecology of the Pediatric Faculty, Pirogov Russian National Research Medical University, Ministry of Health of Russia; CEO and Member of the Board of Directors, Mother and Child Group of Companies
Russian Federation, Moscow; Moscow Region; MoscowOlga L. Malmberg
Lapino Clinical Hospital, “Mother and Child” Group of Companies; MD GROUP Clinical Hospital, “Mother and Child” Group of Companies; Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia
Email: malmberg.olga@gmail.com
PhD, Chief Specialist in Ultrasound Diagnostics, Mother and Child Group of Companies; Associate Professor of the Department of Ultrasound Diagnostics, Russian Medical Academy Continuing Professional Education, Ministry of Health of Russia
Russian Federation, Moscow Region; Moscow; MoscowAshot M. Grigoryan
Lapino Clinical Hospital, “Mother and Child” Group of Companies
Email: malmberg.olga@gmail.com
ORCID iD: 0000-0001-9226-0130
PhD, Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment
Russian Federation, Moscow RegionOlga A. Samsonova
MD GROUP Clinical Hospital, “Mother and Child” Group of Companies; Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia
Email: Usfox79@gmail.com
PhD, ultrasound diagnostics doctor, MD GROUP Clinical Hospital of the Mother and Child Group of Companies; Assistant at the Department of Ultrasound Diagnostics, Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation, Moscow; MoscowBoris T. Mkrtychyan
MD GROUP Clinical Hospital, “Mother and Child” Group of Companies
Email: malmberg.olga@gmail.com
PhD, Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment
Russian Federation, MoscowMaria B. Shamanova
MD GROUP Clinical Hospital, “Mother and Child” Group of Companies
Email: m.shamanova@mcclinics.ru
Deputy Chief Physician, Head of the Miscarriage Department
Russian Federation, MoscowTatiana O. Normantovich
MD GROUP Clinical Hospital, “Mother and Child” Group of Companies
Email: t.normantovich@mcclinics.ru
Chief Physician
Russian Federation, MoscowAnna V. Mamaeva
MD GROUP Clinical Hospital, “Mother and Child” Group of Companies
Email: Doc.mamaeva@yahoo.com
Head of the Department of the Prenatal Diagnosis
Russian Federation, MoscowOleg A. Latyshkevich
Center for Family Planning and Reproduction, Moscow City Healthcare Department
Email: malmberg.olga@gmail.com
PhD, Chief Physician
Russian Federation, MoscowEkaterina A. Gaponenko
MD GROUP Clinical Hospital, “Mother and Child” Group of Companies; Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia
Email: malmberg.olga@gmail.com
ultrasound diagnostics doctor, MD GROUP Clinical Hospital of the Mother and Child Group of Companies; Assistant at the Department of Ultrasound Diagnostics, Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation, Moscow; MoscowEkaterina V. Sysolyatina
Lapino Clinical Hospital, “Mother and Child” Group of Companies
Email: malmberg.olga@gmail.com
PhD, obstetrician-gynecologist
Russian Federation, Moscow RegionReferences
- Курцер М.А., Шаманова М.Б., Мальмберг О.Л., Нормантович Т.О., Николаева Е.В., Суханова Д.И. Зеркальный синдром при осложненном течении беременности монохориальной двойней. Акушерство и гинекология. 2023; 1: 123-8. [Kurtser M.A., Shamanova M.B., Malmberg O.L., Normantovich T.O., Nikolaeva E.V., Sukhanova D.I. Mirror syndrome in complicated monochorionic twin pregnancy. Obstetrics and Gynecology. 2023; (1): 123-8. (in Russian)]. https://dx.doi.org/10.18565/ aig.2022.316.
- Мальмберг О.Л., Курцер М.А., Бугеренко А.Е., Зверева А.В., Суханова Д.И. Раннее нарушение целостности амниотической оболочки и синдром амниотических перетяжек: диагностика и тактика ведения беременности. Акушерство и гинекология. 2020; 10: 148-55. [Malmberg O.L., Kurtser M.A., Bugerenko A.E., Zvereva A.V., Sukhanova D.I. Early amnion integrity impairment and amniotic band syndrome: diagnosis and pregnancy management tactics. Obstetrics and Gynecology. 2020; (10): 148-55. (in Russian)]. https://dx.doi.org/https://dx.doi.org/10.18565/ aig.2020.10.148-155.
- Притыко А.Г., Соколовская Ю.В., Курцер М.А., Спиридонова Е.И., Зверева А.В., Панина Н.Г., Петраки В.Л., Асадов Р.Н., Полякова О.В., Кутакова Ю.Ю., Баранова Е.А. Внутриутробная хирургическая коррекция миеломенингоцеле у плода и ее исходы: пилотное исследование. Педиатрия. Журнал им. Г.Н. Сперанского. 2020; 99(1): 18-24. [Prityko А.G., Sokolovskaya YU.V., Kurtser M.A., Spiridonova E.I., Zvereva A.V., Panina N.G., Petraki V.L., Asadov R.N., Polyakova O.V., Kutakova Yu.Yu., Baranova E.A. Intrauterine surgical correction of the myelomeningocele in a fetus and its outcomes: a pilot study. [Pediatrics. Journal named after G.N. SPERANSKY. 2020; 99(1): 18-24. (in Russian)].
- Moon-Grady A.J., Morris S.A., Belfort M., Chmait R., Dangel J., Devlieger R. et al. International fetal cardiac intervention registry. J. Am. Coll. Cardiol. 2015; 66(4): 388-99. https://dx.doi.org/10.1016/ j.jacc.2015.05.037.
- Siffel C., Riehle-Colarusso T., Oster M.E., Correa A. Survival of children with hypoplastic left heart syndrome. Pediatrics. 2015: 136(4): e864-70. https://dx.doi.org/10.1542/peds.2014-1427.
- Sedmera D., Hu N., Weiss K.M., Keller B.B., Denslow S., Thompson R.P. Cellular changes in experimental left heart hypoplasia. Anat. Rec. 2002; 267(2):137-45. https://dx.doi.org/10.1002/ar.10098.267: 137-45.
- Maxwell D., Allan L., Tynan M.J. Balloon dilatation of the aortic valve in the fetus: a report of two cases. Br. Heart J. 1991; 65(6): 256-8. https://dx.doi.org/ 10.1136/hrt.65.5.256.
- Bradford V.R., Tworetzky W., Callahan R., Wilkins-Haug L.E., Benson C.B., Porras D. et al. Hemodynamic and anatomic changes after fetal aottic valvuloplasty are associated with procedural success and postnatal biventricular circulation. Prenat. Diagn. 2022; 42(10): 1312-22. https://dx.doi.org/10.1002/pd.6216.
- Friedman K.G., Sleeper L.A., Freud L.R., Marshall A.C., Godfrey M.E., Drogosz M. et al. Improved technical success, postnatal outcomes and refined predictors of outcome for fetal aortic valvuloplasty. Ultrasound Obstet. Gynecol. 2018; 52(2): 212-20. https://dx.doi.org/10.1002/uog.17530.
- Prosnitz A.R., Drogosz M., Marshall A.C., Wilkins-Haug L.E., Benson C.B., Sleeper L. et al. Early hemodynamic changes after fetal aortic stenosis valvuloplasty predict biventricular circulation at birth. Prenat. Diagn. 2018; 38(4): 286-92. https://dx.doi.org/10.1002/pd.5232.
- Алекян Б.Г., Григорьян А.М., Балдин В.Л. Транслюминальная баллонная вальвулопластика врожденного клапанного стеноза аорты. В кн.: Алекян Б.Г., ред. Рентгенэндоваскулярная хирургия. М.: ГЭОТАР-Медиа; 2017; т.1: 143-64. [Alekian B.G., Grigoryan A.M., Baldin V.L. Transluminal balloon valvuloplasty of congenital aortic valve stenosis. In: Alekian B.G., ed. Radiographic and endovascular surgery. GEOTAR-Media; 2017; vol.1: 143-64. (in Russian)].
Supplementary files
