Creation of high position fetal balloon atrial septoplasty for hypoplastic left heart syndrome and highly restrictive atrial septum: A case report and literature review

Abstract

Background: Fetal balloon atrial septoplasty (BAS) is performed through the restrictive foramen ovale in fetal cases with established hypoplastic left heart syndrome (HLHS) and an intact or highly restrictive atrial septum (RAS). Methods: In the current report, we present a case of high position BAS in a fetus with HLHS/RAS. Results: Echocardiography confirmed an adequate atrial opening above the foramen ovale and fetal pleural effusion resolved spontaneously 1 day after the procedure. Conclusion: To the best of our knowledge, the creation of a high position hole in the thinner part of the atrial septum, instead of the restrictive tiny hole, has not been reported in fetal cases with HLHS/RAS. Keywords: Congenital heart disease, Fetal balloon atrial septoplasty, Hypoplastic left heart syndrome, Intact or highly restrictive atrial septum