Controversy About a High-Risk and Innovative Fetal Cardiac Intervention.

TitleControversy About a High-Risk and Innovative Fetal Cardiac Intervention.
Publication TypeJournal Article
Year of Publication2018
AuthorsEdwards LAtherton, Justino H, Morris SA, Rychik J, Feudtner C, Lantos JD
JournalPediatrics
Date Published2018 Aug 10
ISSN1098-4275
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.

DOI10.1542/peds.2017-3595
Alternate JournalPediatrics
PubMed ID30097527