Technical Advances and Outcomes of Fetal Atrial Septal Intervention for Restrictive or Intact Atrial Septum
Authors' conclusion
In our cohort, fetuses with R/IAS post-TS-FASI had significantly higher discharge and overall survival rates compared with all other fetuses with R/IAS. Nutmeg lung improved in the majority of TS-FASI cases with post-FASI imaging.
Study context
- Population
- Fetuses with hypoplastic left heart syndrome, double outlet right ventricle with mitral stenosis/atresia, or mitral valve dysplasia and R/IAS from 2012 to 2024 who underwent evaluation for fetal atrial septal intervention (FASI)fetuses with R/IAS, 18 considered extremely high risk and excluded, 42 analysed · FASI 25 · non-FASI 17
- Participants
- 60 fetuses
- Exposure
- (1) those undergoing and not undergoing FASI, and (2) those undergoing technically successful FASI (TS-FASI) and all others
- FASIn = 25
- non-FASIn = 17
- TS-FASIn = 18
- Outcome
- Survival to discharge and overall survival, FASI vs non-FASI
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | TS-FASI | All others |
|---|---|---|
| Survival to discharge and overall survival, TS-FASI vs all others | 72% | 21% |
- Survival to discharge and overall survival, TS-FASI vs all others: discharge P =0.001
- Survival to discharge and overall survival, TS-FASI vs all others: overall survival log-rank P <0.001
Technical success of FASI
- Technically successful FASI cases
- 18
- Survivors after TS-FASI
- 13 (6 post-Glenn, 6 post-Fontan, 1 post-Ross)
- Technical success rate, first 12
- 58%
- Technical success rate, last 13
- 85%
Nutmeg lung on fetal magnetic resonance imaging
- Nutmeg lung among 20 FASI patients with fetal magnetic resonance imaging
- 15 (75%)
- Improved, of the 9 with nutmeg lung and post-TS-FASI fetal magnetic resonance imaging
- 8
Pulmonary vascular resistance before Glenn/Fontan
- TS-FASI survivors with catheterization data with pulmonary vascular resistance <3 Woods units
- 11/13
Safety
- Unsuccessful FASIs
- 7
- Peri-procedural deaths
- 5
- Fetal demise post-FASI
- 1
Original publication
Technical Advances and Outcomes of Fetal Atrial Septal Intervention for Restrictive or Intact Atrial Septum. Circ Cardiovasc Interv. Published 1 September 2025. doi:10.
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