ABC | Volume 112, Nº5, Maio 2019

Diretriz Diretriz Brasileira de Cardiologia Fetal – 2019 Arq Bras Cardiol. 2019; 112(5):600-648 Tabela 8.3 – Objetivos e efeitos das intervenções fetais Anomalia Objetivo da intervenção Efeito CR/NE EAoC com sinais de evolução para a SHCE Abertura da valva Ao para promover fluxo anterógrado, estimular o crescimento das estruturas esquerdas e criar possibilidade de correção biventricular Modifica a doença IIb/B SHCE com SIA intacto ou FO restritivo Abertura do SIA para alívio da hipertensão atrial esquerda; prevenção da vasculopatia pulmonar, melhora da oxigenação ao nascimento Salva vida IIb/C EAoC com insuficiência mitral importante e AE gigante Abertura da valva Ao e/ou do SIA, alívio da hipertensão atrial esquerda e prevenção da vasculopatia pulmonar, melhora da oxigenação ao nascimento Salva vida IIb/C APSI ou EPVC evoluindo com hipoplasia do VD Abertura da valva pulmonar para encorajar o crescimento das estruturas direitas e criar possibilidade de reparo biventricular ou tratar hidropisia fetal em caso de regurgitação tricúspide grave Modifica a doença e/ou salva vida IIb/C AE: átrio esquerdo; Ao: aórtica; APSI: atresia pulmonar com septo íntegro; CR: classe de recomendação; EAoC: estenose aórtica crítica; EPVC: estenose pulmonar valvar crítica; FO: forame oval; NE: nível de evidência; SHCE: síndrome de hioplasia do coração esquerdo; SIA: septo interatrial; VD: ventrículo direito. 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