Successfully performed the second fetal heart catheterization in Vietnam

Accordingly, during the pregnancy examination, pregnant woman NPPA (27 years old, residing in District 3, Ho Chi Minh City) was found to have a fetal heart abnormality at 21 weeks of pregnancy with a diagnosis of progressive aortic valve stenosis. The pregnant woman underwent amniocentesis and genetic Array testing, which showed no abnormalities.

By January 11, the fetus was 29 weeks old with severe aortic valve stenosis. After consultation, fetal and pediatric cardiology experts all determined that if this case did not have urgent fetal intervention, or late intervention after 30 weeks of gestation to dilate the aortic valve, there was a high chance that the fetus would be lost in the womb with a stillbirth rate of more than 50% or the fetus would progress to hypoplastic left ventricle syndrome and 1-ventricular heart wall (after birth, the child would have to undergo multiple surgeries to temporarily return to 1-ventricular circulation or be completely treated with a heart transplant).

Cardiologists agree that fetal cardiac intervention at this time is appropriate. However, it is predicted that the fetal position will not be favorable for cardiac intervention because of excess amniotic fluid, the fetus changes position continuously, the fetal position changes a lot, so it will be difficult to perform the procedure, the procedure may not be successful, and the risk of fetal heart loss during the intervention needs to be explained.

Successfully performed the second fetal interventional cardiology surgery in Vietnam, picture 1 — Doctor Tang Chi Thuong, Director of the Department of Health, along with leaders of two hospitals and the fetal intervention team, consulted before performing the intervention on the pregnant woman and fetus.

The progress of this special surgery was exactly as predicted by pediatric cardiologist. The fetus kept changing positions, making it very difficult to insert the needle into the left ventricle and up to the aortic valve.

The intervention team of Tu Du Hospital took 20 minutes to put the needle in the right position, then transferred it to the heart valve team of Children's Hospital 1 to complete the final important step of dilating the aortic valve. The mother was then monitored in the operating room for another 15 minutes and the condition of the fetal pericardial effusion was stable.

The surgery ended at 11am the same day and was a great success. The pregnant woman was closely monitored after the surgery. By 1pm this afternoon, the pericardial effusion was well controlled, the fetal heart rate was normal, and the mother's condition was stable.

Previously, on January 4, the above-mentioned team from Tu Du Hospital and Children's Hospital 1 also performed the first fetal interventional cardiology surgery in Vietnam. That was the case of pregnant woman L. (born in 1996), who was pregnant for the first time and was monitored in Da Nang . Ms. L. was transferred to Tu Du Hospital because the fetus was found to have a severe heart abnormality, a congenital defect of no pulmonary valve, and hypoplastic right ventricle.

During the monitoring process at Tu Du Hospital, the fetal heart abnormality began to show signs of worsening, with a risk of death in the womb or immediately after birth. However, after intervention to clear the fetal heart valve, ultrasound examination showed that the flow through the fetal pulmonary valve was good, with no pericardial effusion.

The surgical teams of both hospitals ensured absolute precision, with no incidents occurring during the intervention. This is also a success that marks a new step forward in advanced techniques, on par with developed countries in the region.

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