{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T23:10:26Z","timestamp":1740179426039,"version":"3.37.3"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,2,10]],"date-time":"2020-02-10T00:00:00Z","timestamp":1581292800000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n In patients with hypoplastic left heart syndrome (HLHS) premature closure or restriction of the interatrial communication causes severe cyanosis directly after birth with rapid deterioration in clinical state. An ex-utero intrapartum treatment (EXIT) procedure, extracorporal membrane oxygenation (ECMO), and emergency interventional cardiac catheterization or cardiac surgery has to be anticipated and prepared. We report the first case performing foetal atrial septum stenting in such a patient directly before birth to enable uncomplicated interatrial shunting postnatally.<\/jats:p>\n <\/jats:sec>\n \n Case summary<\/jats:title>\n A 31-year-old pregnant woman was referred to our centre for further evaluation of the foetus due to HLHS. In the follow-up study before birth severe restriction of the foramen ovale with increased retrograde flow in the pulmonary veins [0.33 ratio antegrade\/retrograde time velocity integral (TVI)] was detected. After careful consideration foetal atrial septum stenting was performed at 38\u2009+\u20093\u2009weeks of gestation. At 39\u2009+\u20092\u2009weeks of gestation the baby was born by caesarean section followed by an uncomplicated postnatal adaption. On the 7th day of life a Norwood procedure was performed and the baby was discharged on the 63rd postoperative day.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Evaluation of the interatrial communication in foetuses with HLHS should be done carefully just before birth. In the case of severe restriction or closure of the foramen ovale atrial septum stenting just before birth can be considered as an alternative treatment to an EXIT procedure, ECMO, or emergency atrioseptectomy on bypass. However, a very experienced team of paediatric cardiologists and perinatologists with expertise in foetal cardiac interventions is needed to perform this technical difficult procedure.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa005","type":"journal-article","created":{"date-parts":[[2020,2,10]],"date-time":"2020-02-10T09:03:13Z","timestamp":1581325393000},"page":"1-4","source":"Crossref","is-referenced-by-count":5,"title":["Atrial septum stenting in a foetus with hypoplastic left heart syndrome and restrictive foramen ovale: an alternative to emergency atrioseptectomy in the newborn\u2014a case report"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4034-7987","authenticated-orcid":false,"given":"Andreas","family":"Tulzer","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology, Children\u2019s Heart Center Linz, Kepler University Hospital, Krankenhausstrasse 26-30, 4020 Linz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Arzt","sequence":"first","affiliation":[{"name":"Institute of Prenatal Medicine, Kepler University Hospital, Krankenhausstrasse 26-30, 4020 Linz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Prandstetter","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology, Children\u2019s Heart Center Linz, Kepler University Hospital, Krankenhausstrasse 26-30, 4020 Linz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0473-0257","authenticated-orcid":false,"given":"Gerald","family":"Tulzer","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology, Children\u2019s Heart Center Linz, Kepler University Hospital, Krankenhausstrasse 26-30, 4020 Linz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,2,10]]},"reference":[{"key":"2020022804013750700_ytaa005-B1","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1161\/01.CIR.0000135471.17922.17","article-title":"Creation of an atrial septal defect in utero for fetuses with hypoplastic left heart syndrome and intact or highly restrictive atrial septum","volume":"110","author":"Marshall","year":"2004","journal-title":"Circulation"},{"key":"2020022804013750700_ytaa005-B2","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1161\/CIRCULATIONAHA.116.025873","article-title":"Hypoplastic left heart syndrome with intact or restrictive atrial septum: a report from the International Fetal Cardiac Intervention Registry","volume":"136","author":"Jantzen","year":"2017","journal-title":"Circulation"},{"key":"2020022804013750700_ytaa005-B3","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.1016\/j.ijcard.2013.01.173","article-title":"Fetal stenting of the atrial septum: technique and initial results in cardiac lesions with left atrial hypertension","volume":"168","author":"Chaturvedi","year":"2013","journal-title":"Int J Cardiol"},{"key":"2020022804013750700_ytaa005-B4","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1002\/ccd.25098","article-title":"Technical challenges of atrial septal stent placement in fetuses with hypoplastic left heart syndrome and intact atrial septum","volume":"84","author":"Kalish","year":"2014","journal-title":"Catheter Cardiovasc Interv"},{"key":"2020022804013750700_ytaa005-B5","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1002\/pd.2114","article-title":"Results of in utero atrial septoplasty in fetuses with hypoplastic left heart syndrome","volume":"28","author":"Marshall","year":"2008","journal-title":"Prenat Diagn"}],"container-title":["European Heart Journal - 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