Fetal heart surgery may prevent full-blown left heart chamber disorder

September 29, 2009

Surgery performed in fetuses predicted to be born with a syndrome causing severely underdeveloped hearts helped some avoid developing the full-blown disorder and improved heart growth and function, researchers reported in Circulation: Journal of the American Heart Association.

Researchers at Children’s Hospital in Boston used ultrasound images to identify fetuses at high risk of developing hypoplastic left heart syndrome (HLHS), a condition in which the left side of the heart is severely underdeveloped. This leaves the fetuses with only one pumping heart chamber; if this condition is not treated, it is usually fatal soon after birth.

Based on the first 70 attempts at the prenatal intervention from 2000-08, 67 percent of the fetuses had a technically successful procedure and were born at a viable gestational age, researchers said.

Development of the left side of the heart in those who underwent the prenatal intervention clearly improved compared to those who did not.

“By intervening early, we hope to alter the course of and growth before birth and lessen the severity of the defect,” said Doff B. McElhinney, M.D., lead author of the study and an associate in cardiology at Children’s Hospital of Boston, Mass. “The surgery was typically performed between the 20th and 24th week of ; 77 percent of the fetuses were male (the syndrome occurs most often in males).”

McElhinney said the study was most helpful in determining which fetuses were not good candidates for the surgery.

“Based on our analysis, we discovered that fetuses with left heart size and function below certain levels at the time of intervention were very unlikely to achieve the intended result,” McElhinney said. “This will allow us to offer the therapy more selectively and not expose mothers and fetuses to the obvious risk of intervention when there is no chance of helping the heart develop more normally.”

Despite the insights provided by this study, predicting which fetal intervention will result in improved left heart growth and ultimate postnatal survival remains a challenge and requires further investigation, said McElhinney, who is following patients in the study and performing the surgery on additional fetuses.

“We will need more data on outcomes after birth,” said McElhinney, who is also assistant professor of pediatrics at Harvard Medical School. “We hope to be successful by determining the most appropriate cases, which will enhance the risk/benefit profile of the intervention.”

Provided by American Heart Association

Related Stories

Recommended for you

Tiny bilirubin-filled capsules could improve survival of transplanted pancreatic cells

December 18, 2017
By encapsulating bilirubin within tiny nanoparticles, researchers from North Carolina State University and the Ohio State University have improved the survival rates of pancreatic islet cells in vitro in a low-oxygen environment. ...

Tracking effects of a food preservative on the gut microbiome

December 18, 2017
Antimicrobial compounds added to preserve food during storage are believed to be benign and non-toxic to the consumer, but there is "a critical scientific gap in understanding the potential interactions" they may have with ...

Drug found that induces apoptosis in myofibroblasts reducing fibrosis in scleroderma

December 15, 2017
(Medical Xpress)—An international team of researchers has found that the drug navitoclax can induce apoptosis (self-destruction) in myofibroblasts in mice, reducing the spread of fibrosis in scleroderma. In their paper ...

How defeating THOR could bring a hammer down on cancer

December 14, 2017
It turns out Thor, the Norse god of thunder and the Marvel superhero, has special powers when it comes to cancer too.

Researchers track muscle stem cell dynamics in response to injury and aging

December 14, 2017
A new study led by researchers at Sanford Burnham Prebys Medical Discovery Institute (SBP) describes the biology behind why muscle stem cells respond differently to aging or injury. The findings, published in Cell Stem Cell, ...

'Human chronobiome' study informs timing of drug delivery, precision medicine approaches

December 13, 2017
Symptoms and efficacy of medications—and indeed, many aspects of the human body itself—vary by time of day. Physicians tell patients to take their statins at bedtime because the related liver enzymes are more active during ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.