Controversy About a High-Risk and Innovative Fetal Cardiac Intervention.
Document Type
Article
Publication Date
9-2018
Identifier
DOI: 10.1542/peds.2017-3595
Abstract
A 20-week-old fetus was diagnosed with critical pulmonary valve stenosis. Given the ultrasound findings, the outcome was difficult to predict. The fetal cardiologists discussed the possibility of a pulmonary valvuloplasty (an experimental procedure) with the parents, wherein the fetal right ventricle would be punctured with a long 18G needle, and through it, a wire advanced across the pulmonary valve, allowing for balloon dilation of the valve. The experimental procedure had been performed at a handful of centers. There were some reports of success. The parents sought an opinion at one of the referral centers that had tried the procedure. The doctors there recommended against it. The doctors at the original center were unsure whether they should try the procedure. The parents wanted it. In this ethics rounds, doctors and the parents discuss the arguments for and against a high-risk, innovative in utero procedure.
Journal Title
Pediatrics
Volume
142
Issue
3
MeSH Keywords
Balloon Valvuloplasty; Cardiac Catheterization; Clinical Decision-Making; Humans; Infant, Newborn; Male; Pulmonary Valve Stenosis; Risk Factors; Ultrasonography, Prenatal
Keywords
Balloon Valvuloplasty; Cardiac Catheterization; Clinical Decision-Making; Humans; Infant, Newborn; Male; Pulmonary Valve Stenosis; Risk Factors; Ultrasonography, Prenatal
Recommended Citation
Edwards LA, Justino H, Morris SA, et al. Controversy About a High-Risk and Innovative Fetal Cardiac Intervention. Pediatrics. 2018;142(3):e20173595. doi:10.1542/peds.2017-3595
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