1. Fetal Cardiac Interventions

2. Why Are Fetal Cardiac Interventions Performed? Anomalies that lead to stillbirth Anomalies that lead to secondary diseases To prevent ongoing postnatal operations

3. Advanced Fetal Care Centers 4 in the United States – Children’s Hospital of Boston – University of Maryland Medical Center – The Fetal Care Center of Cincinnati – Vanderbilt Children’s Hospital

4. First Successful Procedure in the United States Children’s Hospital of Boston Aortic Stenosis leading to HLHS

5. a. Stenosis & HLHS

6. Jacob Pomrink Born healthy September 2002 Still Alive Underwent Norwood Procedure 2 day after Birth

7. Procedure Massage fetus into favorable position Needle through mother’s abdomen Through uterus Into heart of fetus Catheterization is applied

8. Complications Sheep – Hemopericardium – Hemothorax – Bradycardia – Death

9. Complications cont. Multiple punctures Pericardial stretching *intramuscular injection to paralyze child

10. Facts and Figures Between 1990 and 2001, 18 fetal interventional balloon angioplasty procedures were performed: Eight of these procedures were technically successful. Among the eight technically successful procedures, three remain alive today. Of the 10 technical failures, four underwent postnatal procedures, and remain alive today.