Fetal critical aortic stenosis with natural improvement of hydrops fetalis due to spontaneous relief of severe restrictive atrial communication

The Journal of Obstetrics and Gynaecology Research
Tetsuya IdeJun Yoshimatsu

Abstract

We describe a rare case of fetal critical aortic stenosis with spontaneous relief of severe restrictive atrial communication, resulting in complete resolution of hydrops fetalis in utero. Fetal ultrasonography showed hydrops fetalis caused by critical aortic stenosis with a severely restrictive foramen ovale and severe mitral regurgitation at 23 weeks of gestation. Hydrops fetalis, however, spontaneously resolved, showing an obvious increase of flow through the foramen ovale and pulmonary vein at 26 weeks of gestation. The neonate required balloon dilation of the aortic valve and balloon atrioseptostomy immediately after birth and also received bilateral pulmonary artery banding and arterial duct stenting 1 week later. The patient was in good condition after conversion to biventricular circulation via Ross procedure at 8 months old. The present case suggests that atrioseptostomy as a fetal intervention may improve outcome in even a hydropic condition.

References

Dec 1, 1995·Seminars in Perinatology·T K Knilans
Oct 18, 2005·The Journal of Pediatrics·Audrey C MarshallJames E Lock
Sep 11, 2007·Seminars in Fetal & Neonatal Medicine·Hikoro Matsui, Helena Gardiner
Dec 22, 2007·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·I A Williams, C S Kleinman
May 16, 2009·Heart·H M Gardiner
Feb 4, 2012·American Journal of Medical Genetics. Part a·Carlo Bellini, Raoul C M Hennekam

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Citations

Apr 13, 2019·The Journal of Obstetrics and Gynaecology Research·Takekazu MiyoshiTomoaki Ikeda

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