ABC | Volume 112, Nº5, May 2019

Guideline Brazilian Fetal Cardiology Guidelines – 2019 Arq Bras Cardiol. 2019; 112(5):600-648 Table 8.3 – Aim and effects of fetal interventions Anomaly Intervention aim Effect GOR/LOE CAS with impending HLHS Open the Ao valve to promote anterograde flow, stimulate left structure growth, create possibility of biventricular correction Disease modifying IIb/B HLHS with intact IAS or restrictive FO Open IAS to alleviate left atrial hypertension, prevent pulmonary vasculopathy, improve oxygenation at birth Lifesaving IIb/C CAS with significant mitral regurgitation and giant LA Open Ao valve and/or IAS, alleviate left atrial hypertension and prevent pulmonary vasculopathy, improve oxygenation at birth Lifesaving IIb/C PAIVS or CPS with evolving RV hypoplasia Open pulmonary valve to promote right structure growth and lead to possible biventricular repair; treat fetal hydrops in cases of severe tricuspid regurgitation Disease modifying and/or lifesaving IIb/C Ao: aortic; CAS: critical aortic stenosis; CPS: critical pulmonary stenosis; FO: foramen ovale; GOR: grade of recommendation; HLHS: hypoplastic left heart syndrome; IAS: interatrial septum; LA: left atrium; LOE: level of evidence; PAIVS: pulmonary atresia with intact interventricular septum; RV: right ventricle. Source: Adapted from Donofrio et al. 17 invaluable contributions and consider them co-authors. Their names, in alphabetical sequence, are: AnaMaria Arregui Zilio, Antonio Luiz Piccoli Jr., Camila Ritter, Carlos Augusto Cardoso Pedra, Cleisson Fabio Peralta, Giovana Baldissera, Kenya Venusa Lampert, Luiza Van der Sand, Natássia Miranda Sulis, Stefano Boemler Busato, and Victoria de Bittencourt Antunes. 1. Allan LD, Sharland GK, Milburn A, Lockhart SM, Groves AM, Anderson RH, et al. Prospective diagnosis of 1006 consecutive cases of congenital heart disease in the fetus. J Am Coll Cardiol. 1994;23(6):1452-8. 2. Brick DH, Allan LD. Outcome of prenatally diagnosed congenital heart disease: an update. Pediatr Cardiol. 2002;23(4):449-53. 3. Nomura RM, Brizot ML, Liao AW, HernandezWR, ZugaibM. Conjoined twins and legal authorization for abortion. Rev Assoc Med Bras (1992). 2011;57(2):205-10. 4. Ewigman BG, Crane JP, Frigoletto FD, LeFevre ML, Bain RP, McNellisD. Effect of prenatal ultrasound screening on perinatal outcome: RADIUS Study Group. N Engl J Med. 1993;329(12):821-7. 5. Tegnander E, Eik-Nes SH, Johansen OJ, Linker DT. Prenatal detectionof heart defects at the routine fetal examination at 18 weeks in a nonselectedpopulation. UltrasoundObstet Gynecol. 1995;5(6):372-80. 6. Fermont L, De Geeter B, Aubry MC, Kachaner J, Sidi D. A close collaboration between obstetricians and pediatric cardiologists allows antenatal detection of severe cardiac malformation by 2D echocardiography. In: Doyle EF, Engle ME, Gersony WM, Rashkind WJ, Talner NS. (editors). Pediatric cardiology: proceedings of the secongWorld Congress. New York: Springer-Verlag; 1986. p. 34-7. 7. Garne E, Stoll C, Clementi M; Euroscan Group. Evaluation of prenatal diagnosis of congenital heart diseases by ultrasound: experience from 20 European registries. Ultrasound Obstet Gynecol. 2001;17(5):386-91. 8. Del Bianco A, Russo S, Lacerenza N, Rinaldi M, Rinaldi G, Nappi L, et al. Four chamber view plus three-vessel and trachea view for acomplete evaluation of the fetal heart during the second trimester. J Perinat Med. 2006;34(4):309-12. Erratum in: J Perinat Med. 2006;34(6):509. 9. Marek J, Tomek V, Skovranek J, Povysilova V, Samanek M. Prenatal ultrasound screening of congenital heart disease in an unselected national population: a 21-year experience. Heart. 2011;97(2):124-30. 10. StümpflenI,StümpflenA,WimmerM,BernaschekG.Effectofdetailedfetal echocardiography as part of routine prenatal ultrasonographic screening on detection of congenital heart disease. Lancet. 1996;348(9031):854-7. References 11. Kleinert, Sabine. Routine prenatal screening for congenital heart disease. Lancet. 1996;348(9031):836. 12. LopesLM,DamianoAP,ZugaibM.Programaeducativodetreinamentoem ecocardiografia fetal nível I: impacto na referência e análise de resultados. Rev Bras Ecocardiogr. 2003;16(3):61-8. 13. Wyllie J, Wren C, Hunter S. Screening for fetal cardiacmalformations. Brit Heart J. 1994;71(4 Suppl):20-7. 14. Bonnet D, Coltri A, Butera G, Fermont L, Le Bidois J, Kachaner J, et al. Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality. Circulation. 1999;99(7):916-8. 15. Tworetzky W, McElhinney DB, Reddy MV, Brook MM, Hanley FL, Silverman NH. Improved surgical outcome after fetal diagnosis of hypoplastic left heart syndrome. Circulation. 2001;103(9):1269-73. 16. Franklin O, BurchM, Manning N, Sleeman K, Gould S, Archer N. Prenata l diagnosis of coarctation of the aorta improves survival and reduces morbidity. Heart. 2002;87(1):67-9. 17. Donofrio MT, Moon-Grady AJ, Hornberger LK, Copel JA, Sklansky MS, Abuhamad A, et al; American Heart Association Adults With Congenital Heart Disease Joint Committee of the Council on Cardiovascular Disease in the Young and Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and Council on Cardiovascular and Stroke Nursing. Diagnosis and treatment of fetal cardiac disease a scientific statement from the American Heart Association. Circulation. 2014;129(21):2183-242. Erratum in: Circulation. 2014;129(21):e512. 18. American Institute of Ultrasound in Medicine. AIUM practice guideline for the performance of fetal echocardiography. J Ultrasound Med. 2013;32(6):1067-82. 19. Yoo SJ, Lee YH, Cho KS. Abnormal three-vessel viewon sonography: a clue to the diagnosis of congenital heart disease in the fetus. Am J Roentgenol. 1999;172(3):825-30. 20. Mavrides E, Cobian-Sanchez F, Tekay A, Moscoso G, Campbell S, Thilaganathan B, et al. Limitations of using first-trimester nuchal translucencymeasurement inroutinescreening formajorcongenitalheart. Ultrasound Obstet Gynecol. 2001;17(2):106-10. 641