Faculty Collaboration Database

International Fetal Cardiac Intervention Registry: A Worldwide Collaborative Description and Preliminary Outcomes. J Am Coll Cardiol 2015 Jul 28;66(4):388-99

Date

07/25/2015

Pubmed ID

26205597

DOI

10.1016/j.jacc.2015.05.037

Scopus ID

2-s2.0-84937688548 (requires institutional sign-in at Scopus site)   160 Citations

Abstract

BACKGROUND: Invasive fetal cardiac intervention (FCI) has been reported in single-institution series, promoting technical and physiologic success.

OBJECTIVES: This study describes the creation of an international registry of cases presenting for FCI, intended to compile technical and outcome data from a multicenter cohort.

METHODS: For this initial analysis, the entire database of the International Fetal Cardiac Intervention Registry (IFCIR) was queried for details of diagnoses, procedures, and outcomes. Maternal-fetal dyads from January 2001 through June 2014 were included.

RESULTS: Eighteen institutions submitted data by data harvest. Of 370 cases entered, 245 underwent FCI: 100 aortic valvuloplasties from a previous single-center report (excluded from additional reporting here), an additional 86 aortic and 16 pulmonary valvuloplasties, 37 atrial septal cases, and 6 unclassified cases. FCI did not appear to affect overall survival to hospital discharge. Among live-born infants with a fetal diagnosis of aortic stenosis/evolving hypoplastic left heart syndrome, more than twice as many were discharged with biventricular circulation after successful FCI versus those meeting institutional criteria but without any or successful FCI (42.8% vs. 19.4%, respectively). When fetal deaths were counted as treatment failures, the percentages were similar: biventricular circulation at discharge was 31.3% versus 18.5% for those discharged with univentricular palliation. Survival to discharge for live-born fetuses with atrial restriction was similar to that of those undergoing technically successful versus unsuccessful FCI (63.6% vs. 46.7%, respectively), although criteria for diagnosis were nonuniform.

CONCLUSIONS: We describe the contents of the IFCIR and present post-natal data to suggest potential benefit to fetal therapy among pregnancies considered for possible intervention and support proposals for additional work.

Author List

Moon-Grady AJ, Morris SA, Belfort M, Chmait R, Dangel J, Devlieger R, Emery S, Frommelt M, Galindo A, Gelehrter S, Gembruch U, Grinenco S, Habli M, Herberg U, Jaeggi E, Kilby M, Kontopoulos E, Marantz P, Miller O, Otaño L, Pedra C, Pedra S, Pruetz J, Quintero R, Ryan G, Sharland G, Simpson J, Vlastos E, Tworetzky W, Wilkins-Haug L, Oepkes D, International Fetal Cardiac Intervention Registry

MESH terms used to index this publication - Major topics in bold

Female
Fetal Diseases
Fetal Therapies
Heart Defects, Congenital
Humans
Infant, Newborn
International Cooperation
Pregnancy
Pregnancy Outcome
Registries