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J Thorac Cardiovasc Surg 2007;134:256-257
© 2007 The American Association for Thoracic Surgery

Brief Communication

Fetal transesophageal echocardiography during balloon valvuloplasty for severe aortic valve stenosis at 28+6 weeks of gestation

^a German Center for Fetal Surgery & Minimally-Invasive Therapy, University Hospital of Bonn, Bonn, Germany
^c Department of Pediatric Cardiology, University Hospital of Bonn, Bonn, Germany
^d Department of Neonatal Intensive Care, University Hospital of Bonn, Bonn, Germany
^e Department of Anesthesiology, University Hospital of Bonn, Bonn, Germany
^b Münster University Children’s Hospital, Department of Cardiology, Münster, Germany.

Received for publication January 6, 2006; revisions received January 19, 2006; accepted for publication January 29, 2006.

^_* Address for reprints: Thomas Kohl, MD, German Center for Fetal Surgery & Minimally-Invasive Therapy, Department of Obstetrics & Prenatal Medicine, University of Bonn Medical School, 53105 Bonn, Germany. (Email: thomas.kohl@ukb.uni-bonn.de).

The first 20% of the full text of this article appears below.

Dr Kohl and his son Finn, nicknamed "Professor Schlonkendonk"

Clinical Summary

A 26-year old pregnant women had been referred to our center at 28+1 weeks of gestation. Maternal transabdominal fetal ultrasound imaging at that time revealed severe fetal aortic valve stenosis with a poorly contracting, dilated left ventricle, moderate-to-severe mitral valve regurgitation, and local hyperechogenicity of the endocardium. Left-to-right shunting across the oval foramen and retrograde flow inside the aortic arch heralded loss of left ventricular function with ongoing pregnancy.¹

Percutaneous ultrasound-guided fetal balloon valvuloplasty was performed at 28+6 weeks of gestation to salvage fetal left ventricular function. The procedure was viewed as an experimental treatment approach with the potential to improve quality of life and overall prognosis. Fetal transesophageal echocardiography (TEE) with a multimodal intravascular ultrasound catheter was used to improve imaging of device manipulation inside the fetal heart and aorta.² The ultrasound and fetoscopy-guided procedure was performed after parental informed consent and approval by the local committee of human research and in accordance with the ethical standards for human experimentation established by the Declaration of Helsinki.

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