Fetal Aortic Valvuloplasty for Evolving Hypoplastic Left Heart Syndrome

Overview

Acerca de este estudio

The purpose of this study is to evaluate the outcomes of fetal aortic valvuloplasty performed in cases selected using a refined inclusion criteria (use the 2009 criteria) and exclude group/category (Friedman et al. 20182 – see section 3.3).  Left ventricle pressure ≤ 47 mmHg, MV dimension Z-score < 0.1 and MV inflow time Z-score < -2). Our hypothesis is that utilizing a refined selection criteria the outcomes can be further improved.

Elegibilidad para participar

Los requisitos de elegibilidad de los participantes incluyen la edad, el sexo, el tipo y el estadio de la enfermedad, y los problemas de salud o tratamientos previos. Las pautas difieren de un estudio a otro e identifican quiénes pueden o no pueden participar. No hay garantía de que cada persona elegible que desee participar en un ensayo se inscribirá. Comunícate con el equipo del estudio para analizar la elegibilidad del estudio y la posible participación.

Inclusion Criteria:

* Pregnant women 18-45 years of age.
* Gestational age between 21 0/7 and 29 6/7 weeks of gestation
* The mother must be healthy enough to undergo surgery.
* The individual being enrolled must be able to provide informed consent.
* Dominant cardiac defect is valvar
* Evolving hypoplastic left heart syndrome defined as depressed left ventricle systolic and at least one of the following:

* Retrograde flow in the transverse aortic arch
* Two of the following: (1) left to right flow across the atrial septum (bulging of the septum left to right in cases of intact atrial septum); (2) monophasic mitral valve inflow; (3) bidirectional flow in the pulmonary veins.
* Potential for a technically successful and postnatal biventricular outcome defined as left ventricle long axis Z-score equal or greater than -2 PLUS at least 4 of the following 5 criteria:

* Left ventricle long axis Z-score more than zero
* Left ventricle short axis Z-score more than zero
* Aortic annulus Z-score more than -3.5
* Mitral valve annulus Z-score more than -2
* Left ventricle generating a maximal instantaneous gradient (MIG) equal or greater than 20 mmHg (or by mitral regurgitation jet greater than or equal to 20 mmHg).

Exclusion Criteria:

* Patient is less than 18 years of age or more than 45 years of age.
* Contraindication to anesthesia or surgery
* Preterm labor or cervical length \<20 mm at enrollement or uterine anomaly strongly predisposing to preterm delivery.
* Other fetal anomalies that significantly impact fetal/neonatal survival (e.g., congenital diaphragmatic hernia, bilateral renal agenesis, etc.)
* Fetal aneuploidy and pathogenic findings on Karyotype or Microarray that impact significantly the fetal/neonatal survival.
* Cases with all the following criteria:

* Left ventricle pressure ≤ 47 mmHg
* MV dimension Z-score \< 0.1
* MV inflow time Z-score \< -2

Note: Other protocol defined Inclusion/Exclusion Criteria may apply.

Eligibility last updated 8/12/2024. Questions regarding updates should be directed to the study team contact.

 

Ubicaciones participantes de Mayo Clinic

Los estatus de los estudios cambian con frecuencia. Comunícate con el equipo del estudio para obtener la información más actualizada acerca de la posibilidad de participar.

Ubicación de Mayo Clinic Estado Contacto

Rochester, Minn.

Investigador principal de Mayo Clinic

Mauro Schenone, M.D.

Comunícate con nosotros para obtener los estados más recientes

Contact information:

Hannah Scott

(507) 293-2542

Scott.Hannah3@mayo.edu

More information

Publicaciones

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CLS-20571421

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