{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:11:19Z","timestamp":1788966679839,"version":"build-2803163510"},"reference-count":5,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Fetal balloon aortic valvuloplasty (fBAV) is performed in carefully selected fetuses with critical aortic stenosis to prevent progression to hypoplastic left heart syndrome. We report a fetus with critical aortic stenosis who underwent successful fBAV at 26 weeks\u2019 gestation with restoration of antegrade aortic flow. Serial fetal echocardiography subsequently demonstrated progressive restriction and eventual functional closure of the foramen ovale despite technically successful valvuloplasty. Pulmonary venous Doppler revealed a prominent atrial reversal wave with prolonged reversal duration, while mitral inflow showed marked E-wave predominance, indicating elevated left atrial pressure and severe left ventricular diastolic dysfunction. After birth, the neonate developed pulmonary hypertension physiology with persistently elevated left ventricular end-diastolic pressure despite postnatal balloon aortic valvotomy. This case highlights that pulmonary venous Doppler provides a valuable noninvasive marker of restrictive atrial physiology and may identify fetuses at risk of adverse neonatal hemodynamics despite successful relief of aortic valve obstruction.<\/jats:p>","DOI":"10.4103\/apc.apc_111_26","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:21:18Z","timestamp":1788949278000},"page":"612-615","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary venous Doppler as a marker of restrictive atrial physiology in fetal critical aortic stenosis after fetal valvuloplasty"],"prefix":"10.4103","volume":"19","author":[{"given":"Nageswara Rao","family":"Koneti","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology, Rainbow Children\u2019s Heart Institute, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shweta Nathani","family":"Bakhru","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Rainbow Children\u2019s Heart Institute, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"R1-20260909","doi-asserted-by":"crossref","first-page":"2974","DOI":"10.1161\/CIRCULATIONAHA.105.534180","article-title":"Predictive value of fetal pulmonary venous flow patterns in identifying the need for atrial septoplasty in the newborn with hypoplastic left ventricle","volume":"112","author":"Michelfelder","year":"2005","journal-title":"Circulation"},{"key":"R2-20260909","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":"R3-20260909","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1161\/01.CIR.103.9.1269","article-title":"Improved surgical outcome after fetal diagnosis of hypoplastic left heart syndrome","volume":"103","author":"Tworetzky","year":"2001","journal-title":"Circulation"},{"key":"R4-20260909","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1161\/CIRCULATIONAHA.114.009032","article-title":"Fetal aortic valvuloplasty for evolving hypoplastic left heart syndrome: Postnatal outcomes of the first 100 patients","volume":"130","author":"Freud","year":"2014","journal-title":"Circulation"},{"key":"R5-20260909","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/S0735-1097(99)00225-9","article-title":"The hypoplastic left heart syndrome with intact atrial septum: Atrial morphology, pulmonary vascular histopathology and outcome","volume":"34","author":"Rychik","year":"1999","journal-title":"J Am Coll Cardiol"}],"container-title":["Annals of Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_111_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:18:59Z","timestamp":1788963539000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_111_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":5,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/apc.apc_111_26","relation":{},"ISSN":["0974-2069","0974-5149"],"issn-type":[{"value":"0974-2069","type":"print"},{"value":"0974-5149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-03-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-16","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}