The first experience with intrauterine balloon vulvoplasty in aortic stenosis
Background: Outflow tract obstruction of the left ventricle (LV) is one of the causes of a disorder of its growth and development of hypoplastic left heart syndrome (HLHS). This pathological condition fails to support systemic blood flow and requires postnatal correction, by creating univentricular blood circulation, a palliative operation with a poor vital prognosis for the newborn. Intrauterine balloon vulvoplasty is a method of treatment that contributes to the improvement of LV growth, which in turn increases the likelihood of maintaining biventricular circulation after birth.Kurtser M.A., Malmberg O.L., Grigoryan A.M., Samsonova О.А., Mkrtychyan B.T., Shamanova M.B., Normantovich T.O., Mamaeva A.V., Latyshkevich O.А., Gaponenko Е.А., Sysolyatina E.V.
Case report: The paper describes the authors’ first experience with a cardiac intrauterine intervention in a fetus with critical aortic valve stenosis. It briefly outlines the medical history of a female patient, the time course of changes in ultrasound data, the compliance of ECHO-CG readings to the criteria of the International Fetal Cardiac Intervention Registry, describes the technique of balloon vulvoplasty and presents the early hemodynamic results after intrauterine correction.
Conclusion: The early hemodynamic changes after intrauterine intervention in the fetus with critical aortic valve stenosis confirmed the efficiency of balloon vulvoplasty in this pathology. A further follow-up of neonatal hemodynamic parameters after intrauterine cardiac defect correction is required to assess the long-term results of intrauterine correction.
Authors' contributions: Kurtser M.A. – analysis of the findings; Malmberg O.L. – review of publications on the topic of the articles, analysis of the findings, writing the text of the manuscript; Samsonova O.A. – development of the design of the investigation, data collection, analysis of the findings; Gaponenko E.A., Grigoryan A.M., Mkrtychyan B.T., Shamanova M.B., Normantovich T.O., Latyshkevich О.A., Sysolyatina E.V., Mamaeva A.V. – data collection; analysis of the findings.
Conflicts of interest: The authors declare that the authors declare that there are no conflicts of interest.
Funding: The investigation has not been sponsored.
Ethical Approval: The approval of the Ethics Committee had been obtained for performing an operation of intrauterine balloon vulvoplasty.
Patient Consent for Publication: The patient provided informed consent for the publication of her data and associated images.
For citation: Kurtser M.A., Malmberg O.L., Grigoryan A.M., Samsonova О.А., Mkrtychyan B.T., Shamanova M.B., Normantovich T.O., Mamaeva A.V., Latyshkevich O.А., Gaponenko Е.А., Sysolyatina E.V. The first experience with intrauterine balloon vulvoplasty in aortic stenosis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (5): 153-158 (in Russian)
https://dx.doi.org/10.18565/aig.2023.61
Keywords
aortic stenosis
intrauterine balloon vulvoplasty
fetal surgery
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Received 07.03.2023
Accepted 26.04.2023
About the Authors
Mark A. Kurtser, Academician of the Russian Academy of Sciences, Head of the Department of Obstetrics and Gynecology of the Pediatric Faculty, Pirogov Russian National Research Medical University, Ministry of Health of Russia; CEO and Member of the Board of Directors, Mother and Child Group of Companies,117209, Russia, Moscow, Sevastopol Ave., 24 build.1.
Olga L. Malmberg, PhD, Chief Specialist in Ultrasound Diagnostics, Mother and Child Group of Companies; Associate Professor of the Department of Ultrasound Diagnostics, Russian Medical Academy Continuing Professional Education, Ministry of Health of Russia, +7(916)512-82-91, malmberg.olga@gmail.com,
117209, Russia, Moscow, Sevastopol Ave., 24 build. 1.
Ashot M. Grigoryan, PhD, Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment, Lapino Clinical Hospital of the Mother and Child Group of Companies, https://orcid.org/0000-0001-9226-0130, 143081, Russia, Moscow region, Lapino, 1st Uspenskoe Highway, 111.
Olga A. Samsonova, PhD, ultrasound diagnostics doctor, MD GROUP Clinical Hospital of the Mother and Child Group of Companies; Assistant at the Department of Ultrasound Diagnostics, Pirogov Russian National Research Medical University, Ministry of Health of Russia, +7(915)202-11-73, Usfox79@gmail.com,
117209, Russia, Moscow, Sevastopol Ave., 24, build. 1.
Boris T. Mkrtychyan, PhD, Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment, MD GROUP Clinical Hospital of the Mother and Child Group of Companies, +7(916)858-94-77, 117209, Russia, Moscow, Sevastopol Ave., 24, build. 1.
Maria B. Shamanova, Deputy Chief Physician, Head of the Miscarriage Department, MD GROUP Clinical Hospital of the Mother and Child Group of Companies,
+7(916)806-25-98, m.shamanova@mcclinics.ru, 117209, Russia, Moscow, Sevastopol Ave., 24, build. 1.
Tatiana O. Normantovich, Chief Physician, MD GROUP Clinical Hospital of the Mother and Child Group of Companies, t.normantovich@mcclinics.ru,
117209, Russia, Moscow, Sevastopol Ave., 24, build. 1.
Anna V. Mamaeva, Head of the Department of the Prenatal Diagnosis, MD GROUP Clinical Hospital of the Mother and Child Group of Companies,
+7(906)717-77-77, Doc.mamaeva@yahoo.com, 117209, Russia, Moscow, Sevastopol Ave., 24, build. 1.
Oleg A. Latyshkevich, PhD, Chief Physician , Family Planning and Reproduction Center of Moscow Healthcare Department, +7(916)629-90-01,
117209, Russia, Moscow, Sevastopol Ave., 24A.
Ekaterina A. Gaponenko, ultrasound diagnostics doctor, MD GROUP Clinical Hospital of the Mother and Child Group of Companies; Assistant at the Department of Ultrasound Diagnostics, Pirogov Russian National Research Medical University, Ministry of Health of Russia, 117209, Russia, Moscow, Sevastopol Ave., 24, build. 1.
Ekaterina V. Sysolyatina, PhD, obstetrician-gynecologist, Lapino Clinical Hospital of the Mother and Child Group of Companies, +7(916)667-77-35,
143081, Russia, Moscow region, Lapino, 1st Uspenskoe Highway, 111.
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