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Fetal Cardiology Program

Fetal Cardiology Program

The Fetal Cardiology Program at Texas Children’s Fetal Center provides not only expert fetal cardiac care by a highly experienced multidisciplinary team, but also supports families during a difficult time as they wait to see how their unborn baby’s heart develops through close monitoring, diagnosis and counseling.

Fetal cardiac care is provided by a team of dedicated pediatric cardiologists, sonographers and clinical specialists. The team performs over 2,000 fetal cardiac examinations annually. In addition, we provide diagnosis, counseling, and management of congenital heart defects and acquired fetal cardiac diseases.

The Fetal Cardiology Program is part of the #1 ranked Texas Children’s Heart Center.

Support and preparation for the family is also an important focus for the team. With this in mind, our Fetal Cardiology Program works in conjunction with many other teams at Texas Children’s Hospital to provide the most comprehensive diagnosis, monitoring, and educational resources. These resources include a unique prenatal class for families whose newborns will be going from delivery to a intensive care unit for further newborn care.

The fetal cardiac team works closely with experts in maternal fetal medicine, fetal surgery, genetics, fetal radiology, neonatology, and obstetrics to provide support of fetuses with a wide spectrum of problems that can impact the fetal heart. Our team approach means that when you deliver at Texas Children’s, you and your baby both receive all your care under one roof. This relieves your family of the stress of having mother and baby separated to be treated at two different institutions.

Approximately half of all patients referred to Texas Children’s Fetal Center are seen for cardiac issues.

Our specialists also perform fetal cardiac interventions, and provide cardiac monitoring and support during fetal non-cardiac interventions.

Fetal cardiac interventions for HLHS and associated conditions

Hypoplastic left heart syndrome (HLHS) is a complex congenital heart defect that occurs when the left side of the heart does not form properly. The mitral valve, the left ventricle and the aortic valve are too small, and there is not enough blood pumping through the left side of the heart to support the rest of the body. Related conditions include evolving HLHS, where the valve is beginning to narrow and there is concern that the baby will have HLHS by the time of birth, and borderline left heart, where multiple left-sided structures are smaller than they should be. Texas Children’s Hospital has successfully performed in-utero fetal cardiac interventions for all three conditions. A coordinated effort among a large, multidisciplinary team of fetal cardiologists, obstetricians and gynecologists, interventional cardiologists, congenital heart surgeons, fetal imaging experts, maternal and fetal anesthesiologists and other clinical specialists, Texas Children’s Hospital is the first in the southwestern U.S. to create a program to treat these defects in utero.

Catheter-based fetal aortic valvuloplasty for fetal aortic stenosis (evolving HLHS)

We perform this catheter-based procedure for babies with severe aortic stenosis in utero (evolving HLHS). A tiny balloon is inflated inside the aortic valve to open up the leaflets, which is then removed.This allows blood to flow more easily through the left side of the fetal heart and potentially improve growth of left-sided structures.

Fetal AS baseline

Fetal valvuloplasty for AS intervention

Fetal AS post-intervention

Fetal AS baseline Fetal valvuloplasty for
AS intervention
Fetal AS post-intervention

Catheter-based atrial septal interventions for HLHS with intact or restrictive atrial septum (RAS)

Babies who already have HLHS in utero with no potential for growth of the left-sided structure depend on a hole in the atrial septum to keep blood circulating throughout their body. In some babies, this hole either does not exist or it is too small, and they have a high risk of complications and death. In a catheter-based procedure, we use a balloon or stent to create an atrial septal defect (a hole between the top chambers of the heart) to keep blood flowing through the fetal heart.

HLHS with RAS 
HLHS with RAS after
stent placement

Chronic hyper-oxygenation for borderline left heart

For fetuses with borderline left heart, Texas Children’s Fetal Center is the first in the country to offer a brand new research protocol in which mothers receive daily oxygen therapy throughout their third trimester. By delivering extra oxygen to the mother through face mask or cannula, we hope to increase the amount of oxygen in her blood, the amount of oxygen going to the placenta and fetus, and ultimately the amount of oxygen flowing into the fetal lungs and into the left side of the baby’s heart. By improving flow to the left side of the heart, growth should improve as well. Nine mothers have participated in the trial so far.

Borderline left heart