{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:30:23Z","timestamp":1787808623766,"version":"build-2784847793"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,15]],"date-time":"2025-02-15T00:00:00Z","timestamp":1739577600000},"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":[[2025,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To analyze the prevalence and severity of fetal aortic regurgitation (AR) after undergoing successful fetal aortic valvuloplasty (FAV) and to evaluate its effects on fetal circulation and left ventricular (LV) growth.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This was a retrospective review of all fetuses with critical aortic stenosis who underwent successful FAV at our center between 2010 and 2024 for whom postnatal echocardiograms were available in digital format. Fetal and postnatal echocardiographic examinations were analyzed for ventricular and valvular dimensions and characteristics, and\n Z\u2010<\/jats:italic>\n scores were calculated for middle cerebral artery (MCA) pulsatility index (PI), umbilical artery (UA) PI and cerebroplacental ratio. AR severity was classified into no\/mild AR or significant (moderate\/severe) AR. The balloon\u2010to\u2010aortic valve ratio (BVR) was calculated as the ratio between the maximum actual balloon diameter and the aortic valve (AV) annulus diameter. The primary endpoints of this study were the prevalence, severity and risk factors for fetal AR following successful FAV.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Ninety\u2010nine fetuses who underwent successful FAV were included. Immediate post\u2010FAV echocardiograms showed that 87% of fetuses developed some degree of AR, including 45% of all fetuses with significant AR. BVR was significantly higher in fetuses with significant AR compared to those with no\/mild AR (mean, 1.09 (95%\u2009CI, 1.06\u20131.12)\n vs<\/jats:italic>\n 1.02 (95%\u2009CI, 0.99\u20131.04);\n P<\/jats:italic>\n \u2009<\u20090.001). In\u00a0a subgroup of 66\/99 fetuses with available postnatal echocardiograms, the prevalence of AR decreased significantly from 86% before birth to 58% after birth (\n P<\/jats:italic>\n \u2009<\u20090.001), with the proportion of fetuses with significant AR reducing from 47% before birth to 17% after birth (\n P<\/jats:italic>\n \u2009<\u20090.001). In the overall cohort of fetuses, AV maximum velocity (Vmax) increased significantly from post\u2010FAV to after birth (mean, 1.93 (95%\u2009CI, 1.75\u20132.11)\u2009m\/s\n vs<\/jats:italic>\n 3.21 (95%\u2009CI, 2.89\u20133.55)\u2009m\/s;\n P<\/jats:italic>\n \u2009<\u20090.001), regardless of AR severity, but Vmax after birth was lower in the significant\u2010AR group compared with the no\/mild\u2010AR group (mean, 2.85\u2009m\/s\n vs<\/jats:italic>\n 3.55\u2009m\/s;\n P<\/jats:italic>\n \u2009=\u20090.020). Fetuses with significant AR exhibited higher relative LV length increases from immediately post\u2010FAV to after birth than did those with no\/mild AR (25% (95%\u2009CI, 16\u201333%)\n vs<\/jats:italic>\n 14% (95%\u2009CI, 6\u201321%);\n P<\/jats:italic>\n \u2009=\u20090.044), although there was no significant difference in mean LV length\n Z\u2010<\/jats:italic>\n score after birth between the two groups. FAV led to significant short\u2010term increases in MCA\u2010PI and UA\u2010PI\n Z\u2010<\/jats:italic>\n scores, with greater increases observed in fetuses with significant AR.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n FAV is associated with a high prevalence of fetal AR, which lessens in severity over the course of gestation. Significant fetal AR had the largest association with greater BVR and had significant impact on fetal hemodynamics. \u00a9 2025 The Author(s).\n Ultrasound in Obstetrics & Gynecology<\/jats:italic>\n published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.29182","type":"journal-article","created":{"date-parts":[[2025,2,15]],"date-time":"2025-02-15T11:39:56Z","timestamp":1739619596000},"page":"325-333","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Postinterventional fetal aortic regurgitation: prevalence, outcome and effects on fetal circulation in large single\u2010center cohort"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4034-7987","authenticated-orcid":false,"given":"A.","family":"Tulzer","sequence":"first","affiliation":[{"name":"Children's Heart Center Linz, Department of Pediatric Cardiology Kepler University Hospital Linz Austria"},{"name":"Medical Faculty Johannes Kepler University Linz Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Hochpoechler","sequence":"additional","affiliation":[{"name":"Children's Heart Center Linz, Department of Pediatric Cardiology Kepler University Hospital Linz Austria"},{"name":"Medical Faculty Johannes Kepler University Linz Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Scharnreitner","sequence":"additional","affiliation":[{"name":"Medical Faculty Johannes Kepler University Linz Linz Austria"},{"name":"Department of Gynecology, Obstetrics and Gynecological Endocrinology Kepler University Hospital Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Tomek","sequence":"additional","affiliation":[{"name":"Children's Heart Center, Second Faculty of Medicine Charles University in Prague and Motol University Hospital Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Weber","sequence":"additional","affiliation":[{"name":"Pediatric Heart Center Zurich University Children's Hospital Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Sames\u2010Dolzer","sequence":"additional","affiliation":[{"name":"Medical Faculty Johannes Kepler University Linz Linz Austria"},{"name":"Children's Heart Center Linz, Division of Pediatric and Congenital Cardiac Surgery Kepler University Hospital Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kreuzer","sequence":"additional","affiliation":[{"name":"Medical Faculty Johannes Kepler University Linz Linz Austria"},{"name":"Children's Heart Center Linz, Division of Pediatric and Congenital Cardiac Surgery Kepler University Hospital Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Mair","sequence":"additional","affiliation":[{"name":"Medical Faculty Johannes Kepler University Linz Linz Austria"},{"name":"Children's Heart Center Linz, Division of Pediatric and Congenital Cardiac Surgery Kepler University Hospital Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Mair","sequence":"additional","affiliation":[{"name":"Medical Faculty Johannes Kepler University Linz Linz Austria"},{"name":"Children's Heart Center Linz, Division of Pediatric and Congenital Cardiac Surgery Kepler University Hospital Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0473-0257","authenticated-orcid":false,"given":"G.","family":"Tulzer","sequence":"additional","affiliation":[{"name":"Children's Heart Center Linz, Department of Pediatric Cardiology Kepler University Hospital Linz Austria"},{"name":"Medical Faculty Johannes Kepler University Linz Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,15]]},"reference":[{"issue":"6","key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1002\/uog.8927","article-title":"Intrauterine aortic valvuloplasty in fetuses with critical aortic stenosis: experience and results of 24 procedures","volume":"37","author":"Arzt W","year":"2011","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"5","key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1002\/uog.24792","article-title":"Valvuloplasty in 103 fetuses with critical aortic stenosis: outcome and new predictors for postnatal circulation","volume":"59","author":"Tulzer A","year":"2022","journal-title":"Ultrasound Obstet 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congenital heart disease: the brain sparing effect","volume":"24","author":"Donofrio MT","year":"2003","journal-title":"Pediatr Cardiol"},{"issue":"4","key":"e_1_2_7_19_1","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1017\/S1047951122002566","article-title":"Prenatal aortic valvuloplasty as a definite treatment in fetuses with critical aortic stenosis, severe mitral regurgitation and giant left atrium: a report of two cases with medium\u2010term follow\u2010up","volume":"33","author":"Tulzer A","year":"2023","journal-title":"Cardiol Young"}],"container-title":["Ultrasound in Obstetrics & 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