In most cases, this leads to improved postnatal management. Heart abnormalities can now be accurately diagnosed before birth by fetal echocardiography. Abnormal development of either one of the pumping chambers (right or left ventricle) can lead to devastating problems after birth, which often require multiple complex open heart surgeries and, even when successful, result in distinctly abnormal function (so-called ‘single ventricle physiology’).Ībnormalities of the heart’s conduction system can result in abnormalities of the heart rhythm referred to as “dysrhythmias” or “arrhythmias”. In the same way, narrowing of the pulmonary valve can damage the developing right ventricle or pumping chamber that normally pumps to the lungs. In these cases, relief of the obstruction while the baby is still in the womb may allow more normal development of the ventricle, thus resulting in a very different outlook for the infant after birth. Ultimately this may result in the development of “hypoplastic left heart syndrome,” one of the most serious and common heart defects we encounter in sick newborns. For instance, severe obstruction of the aortic valve, the outlet valve through which the left ventricle pumps blood to the body, may lead to poor growth and function of the left ventricle and other left heart structures.
There are also a few structural abnormalities (such as narrowing of a valve) that can interfere with development of the pumping chambers, which can be very difficult to fix after birth. Most common heart defects, such as holes between the chambers (atrial septal defect, ventricular septal defect) and even more complex conditions such as transposition of the great arteries and tetralogy of Fallot, can be successfully managed after birth. It is not surprising that small errors in development can lead to a wide variety of structural abnormalities in the 4 chambers, the 4 heart valves, the veins and great arteries. The fetal heart starts as a tube which folds and fuses in a complex dance that results in a muscular pump with four chambers and four valves.
What is congenital heart disease?įetal congenital heart disease involves an abnormality of the heart, whether it is a structural defect, a problem with the fetal heartbeat, or a functional problem with the heart squeeze or filling. The Fetal Treatment Center work directly with members of the UCSF Fetal Cardiovascular Program in the diagnosis and treatment of fetal congenital diseases.
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