{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T21:45:34Z","timestamp":1789076734274,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2007,9,3]],"date-time":"2007-09-03T00:00:00Z","timestamp":1188777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2007,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Severe aortic stenosis in the mid\u2010gestation fetus can progress to hypoplastic left heart syndrome (HLHS).  @ In\u2010utero aortic valvuloplasty is an innovative therapy to promote left ventricular growth and function and potentially to prevent HLHS. This study evaluated the effects of mid\u2010gestation fetal balloon aortic valvuloplasty on subsequent fetal left ventricular function and left heart Doppler characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed fetuses with aortic stenosis that underwent attempted in\u2010utero aortic valvuloplasty between 2000 and 2006. Pre\u2010intervention and the latest post\u2010intervention fetal echocardiograms were analyzed to characterize changes in left heart function and Doppler characteristics in utero.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010two fetuses underwent attempted aortic valvuloplasty during the study period, 12 of which were excluded from analysis secondary to inadequate follow\u2010up data, termination or fetal demise. Study fetuses (<jats:italic>n<\/jats:italic> = 30) underwent pre\u2010intervention echocardiography at a median gestational age of 23 weeks, and were followed for a median of 66 \u00b1 23 days post\u2010intervention. In 26 fetuses, aortic valvuloplasty was technically successful. Among these 26, left heart physiology was abnormal pre\u2010intervention and improved or normalized after intervention in most cases: biphasic mitral inflow was present in 5\/25 (20%) cases pre\u2010intervention and in 21\/23 (91%) post\u2010intervention (<jats:italic>P<\/jats:italic> &lt; 0.001); moderate or severe mitral regurgitation was present in 14\/26 (54%) cases pre\u2010intervention and in 5\/23 (22%) post\u2010intervention (<jats:italic>P<\/jats:italic> = 0.02); bidirectional flow across the patent foramen ovale was present in 0\/26 cases pre\u2010intervention and in 6\/25 (24%) post\u2010intervention (<jats:italic>P<\/jats:italic> = 0.01); antegrade flow in the transverse arch was present in 0\/25 cases pre\u2010intervention and in 17\/26 (65%) post\u2010intervention (<jats:italic>P<\/jats:italic> &lt; 0.001). The left ventricular ejection fraction increased from 19 \u00b1 10% pre\u2010intervention to 39 \u00b1 14% post\u2010intervention (<jats:italic>P<\/jats:italic> &lt; 0.001). These changes were not observed in control fetuses (<jats:italic>n<\/jats:italic> = 18).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fetal aortic valvuloplasty, when technically successful, improves left ventricular systolic function and left heart Doppler characteristics. Copyright \u00a9 2007 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.5132","type":"journal-article","created":{"date-parts":[[2007,9,3]],"date-time":"2007-09-03T11:47:52Z","timestamp":1188820072000},"page":"715-720","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":85,"title":["Changes in left heart hemodynamics after technically successful <i>in\u2010utero<\/i> aortic valvuloplasty"],"prefix":"10.1002","volume":"30","author":[{"given":"E. S.","family":"Selamet Tierney","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. M.","family":"Wald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. B.","family":"McElhinney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. C.","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. B.","family":"Benson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. D.","family":"Colan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. N.","family":"Marcus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. R.","family":"Marx","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. C.","family":"Levine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Wilkins\u2010Haug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. E.","family":"Lock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Tworetzky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,9,3]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(89)90226-X"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.66.6.419"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(92)90834-I"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.6.1531"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.77.3.205"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.58.2.354"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.588194"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.65.5.256"},{"key":"e_1_2_6_10_2","first-page":"162A","article-title":"Aortic balloon valvuloplasty in the human fetus under ultrasound guidance: a report of two cases","volume":"4","author":"Chaoui R","year":"1994","journal-title":"Ultrasound Obstet Gynecol"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1995.05020090.x"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1159\/000264318"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)00733-5"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000144357.29279.54"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2005.04.055"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002469900497"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(99)80365-8"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.5132","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.5132","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T08:51:21Z","timestamp":1696668681000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.5132"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,9,3]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2007,10]]}},"alternative-id":["10.1002\/uog.5132"],"URL":"https:\/\/doi.org\/10.1002\/uog.5132","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,9,3]]},"assertion":[{"value":"2007-04-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2007-09-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}