Details

Autor(en) / Beteiligte

• Gijtenbeek, Manon
• Morris, Shaine A
• Moon-Grady, Anita
• Armstrong, Aimee K
• Cruz-Lemini, Monica
• Dangel, Joanna
• Emery, Stephen P
• Galindo, Alberto
• Gelehrter, Sarah
• Grinenco, Sofia
• Herberg, Ulrike
• Jaeggi, Edgar T
• Malekzadeh-Milani, Sophie
• Pedra, Simone R
• Pruetz, Jay D
• Simpson, John
• Monique, Haak C

Titel

Abstract 16215: Success Rate of Fetal Aortic Valvuloplasty in Relation to Center Volumes: A Report From the International Fetal Cardiac Intervention Registry

Ist Teil von

• Circulation (New York, N.Y.), 2019-11, Vol.140 (Suppl_1 Suppl 1), p.A16215-A16215

Ort / Verlag

by the American College of Cardiology Foundation and the American Heart Association, Inc

Erscheinungsjahr

2019

Quelle

EZB Free E-Journals

Beschreibungen/Notizen

• IntroductionThe impact of center volume on the procedural outcomes of fetal aortic valvuloplasty (FAV) is unknown. The relationship between volume and outcome is crucial to understand if regionalization should be implemented worldwide.HypothesisWe hypothesized that higher center volume is associated with greater technical success in FAV.MethodsData were included from institutions that performed ≥3 procedures (2001-2018) and reported technical success. Technical success was defined as ≥1 balloon inflation across the aortic valve, with clear evidence of increased flow across the valve and/or new aortic regurgitation by color Doppler. Secondary endpoint measures were fetal periprocedural complications (pericardial/pleural effusion or bradycardia requiring treatment, balloon rupture, or death within 48 hours of the procedure) and fetal periprocedural death.ResultsA total of 162 FAVs from 11 centers were included, with FAV center volumes ranging from 6-31. Overall technical success rate was 80%. Higher center volume was not associated with technical success or fetal complications (p=0.948 and p=0.953 respectively), but was associated with fewer periprocedural fetal deaths (p=0.02, Figure). Periprocedural fetal death rate appeared to plateau after 15 FAVs. Intervention in larger fetuses was associated with greater technical success (p<0.001), fewer complications (p=0.01), and fewer periprocedural deaths (p<0.01). Intervention in older fetuses trended towards greater technical success (p=0.08), with significantly fewer complications (p<0.01) and periprocedural deaths (p<0.01). There were 3 significant maternal complications (1.9%) with no association with center volume.ConclusionsIn this registry cohort, higher volume centers did not have more FAV technical success or fewer complications, but they did have fewer fetal deaths. Improved FAV outcomes are associated with larger and older fetuses.