TY - JOUR
T1 - International Fetal Cardiac Intervention Registry
T2 - A Worldwide Collaborative Description and Preliminary Outcomes
AU - Moon-Grady, Anita J
AU - Morris, Shaine A
AU - Belfort, Michael
AU - Chmait, Ramen
AU - Dangel, Joanna
AU - Devlieger, Roland
AU - Emery, Stephen
AU - Frommelt, Michele
AU - Galindo, Alberto
AU - Gelehrter, Sarah
AU - Gembruch, Ulrich
AU - Grinenco, Sofia
AU - Habli, Mounira
AU - Herberg, Ulrike
AU - Jaeggi, Edgar
AU - Kilby, Mark
AU - Kontopoulos, Eftichia
AU - Marantz, Pablo
AU - Miller, Owen
AU - Otaño, Lucas
AU - Pedra, Carlos
AU - Pedra, Simone
AU - Pruetz, Jay
AU - Quintero, Ruben
AU - Ryan, Greg
AU - Sharland, Gurleen
AU - Simpson, John
AU - Vlastos, Emanuel
AU - Tworetzky, Wayne
AU - Wilkins-Haug, Louise
AU - Oepkes, Dick
AU - International Fetal Cardiac Intervention Registry
N1 - Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2015/7/28
Y1 - 2015/7/28
N2 - 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.
AB - 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.
KW - Female
KW - Fetal Diseases
KW - Fetal Therapies
KW - Heart Defects, Congenital
KW - Humans
KW - Infant, Newborn
KW - International Cooperation
KW - Pregnancy
KW - Pregnancy Outcome
KW - Registries
U2 - 10.1016/j.jacc.2015.05.037
DO - 10.1016/j.jacc.2015.05.037
M3 - Article
C2 - 26205597
SN - 0735-1097
VL - 66
SP - 388
EP - 399
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 4
ER -