{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T15:41:07Z","timestamp":1781278867121,"version":"3.54.1"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Fetal aortic valvuloplasty (FAV) has become a treatment option for critical fetal aortic stenosis (AS) with the goal of preserving biventricular circulation (BVC); however, to date, it is unclear how many patients undergoing FAV achieve BVC. The aim of this systematic review and meta\u2010analysis was to investigate the type of postnatal circulation achieved following FAV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses (PRISMA) guidelines were followed. MEDLINE, EMBASE, Web of Science and the Cochrane Library were searched systematically for studies investigating postnatal circulation in patients with AS following FAV. Eligible for inclusion were original papers in the English language, published from 2000 to 2020, with at least 12\u2009months of follow\u2010up after birth. Review papers, abstracts, expert opinions, books, editorials and case reports were excluded. The titles and abstracts of all retrieved literature were screened, duplicates were excluded and the full texts of potentially eligible articles were obtained and assessed. The primary endpoint was type of postnatal circulation. Additional assessed outcomes included fetal death, live birth, neonatal death (NND), termination of pregnancy (TOP) and technical success of the FAV procedure. The quality of articles was assessed using the Critical Appraisal Skills Programme (CASP) tool. To estimate the overall proportion of each endpoint, meta\u2010analysis of proportions was employed using a random\u2010effects model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The electronic search identified 579 studies, of which seven were considered eligible for inclusion in the systematic review and meta\u2010analysis. A total of 266 fetuses underwent FAV with median  follow\u2010up per study from 12\u2009months to 13.2\u2009years. There were no maternal deaths and only one case of FAV\u2010related maternal complication was reported. Hydrops was present in 29 (11%) patients. The pooled prevalence of BVC and univentricular circulation (UVC) among liveborn patients was 45.8% (95%\u2009CI, 39.2\u201352.4%) and 43.6% (95%\u2009CI, 33.9\u201353.8%), respectively. The pooled prevalence of technically successful FAV procedure was 82.1% (95%\u2009CI, 74.3\u201387.9%), of fetal death it was 16.0% (95%\u2009CI, 11.2\u201322.4%), of TOP 5.7% (95%\u2009CI, 2.0\u201315.5%), of live birth 78.8% (95%\u2009CI, 66.5\u201387.4%), of NND 8.7% (95%\u2009CI, 4.7\u201315.5%), of palliative care 4.0% (95%\u2009CI, 1.9\u20138.4%) and of infant death 10.3% (95%\u2009CI, 3.6\u201326.1%). The pooled prevalence of BVC and UVC among liveborn patients who had technically successful FAV was 51.9% (95%\u2009CI, 44.7\u201359.1%) and 39.8% (95%\u2009CI, 29.7\u201350.9%), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study showed a BVC rate of 46% among liveborn patients with AS undergoing FAV, which improved to 52% when subjects underwent technically successful FAV. Given the lack of randomized clinical trials, results should be interpreted with caution. Currently, data do not suggest a true benefit of FAV for achieving BVC. \u00a9 2022 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.24807","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T20:37:28Z","timestamp":1635885448000},"page":"576-584","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Postnatal circulation in patients with aortic stenosis undergoing fetal aortic valvuloplasty: systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7499-8115","authenticated-orcid":false,"given":"C. N.","family":"Vorisek","sequence":"first","affiliation":[{"name":"Dresden International University, Division of Health Care Sciences  Dresden Germany"},{"name":"Berlin Institute of Health at Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Zurakowski","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Department of Anesthesia Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Tamayo","sequence":"additional","affiliation":[{"name":"Dresden International University, Division of Health Care Sciences  Dresden Germany"},{"name":"The Max Rady Faculty of Health Sciences University of Manitoba  Winnipeg Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Axt\u2010Fliedner","sequence":"additional","affiliation":[{"name":"Justus\u2010Liebig\u2010University Giessen  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Siepmann","sequence":"additional","affiliation":[{"name":"Dresden International University, Division of Health Care Sciences  Dresden Germany"},{"name":"University Hospital Carl Gustav Carus Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Friehs","sequence":"additional","affiliation":[{"name":"Dresden International University, Division of Health Care Sciences  Dresden Germany"},{"name":"Harvard Medical School, Boston Children's Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.025"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.77.3.205"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.05.020"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.65.5.256"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000144357.29279.54"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.848994"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(92)90834-I"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.588194"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2006.06.006"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24733"},{"key":"e_1_2_8_13_1","volume-title":"Methodolgy, Perspectives and Application","author":"Systematic Reviews in Educational Research","year":"2020"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"e_1_2_8_15_1","unstructured":"Critical Appraisal Skills Programme(2018). 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