Introduction: Fetuses with hypoplastic left heart syndrome (HLHS) and intact atrial septum (IAS) have an overall poor prognosis and a high risk of neonatal death due to severe secondary lung damage. Intrauterine stenting of the atrial septum was introduced in these patients to enable survival. Case Presentation: We present a case of a HLHS fetus with IAS and signs of incipient nutmeg lung, in whom at 30 weeks gestation an atrial stent was successfully placed but continuously developed subtotal stent-obstruction over the next weeks. Conclusion: Continuous obstruction of placed atrial septum stents until delivery is possible and requires close monitoring of successfully treated fetuses.

1.
Graziano
JN
,
Heidelberger
KP
,
Ensing
GJ
,
Gomez
CA
,
Ludomirsky
A
.
The influence of a restrictive atrial septal defect on pulmonary vascular morphology in patients with hypoplastic left heart syndrome
.
Pediatr Cardiol
.
2002
;
23
(
2
):
146
51
.
2.
Rychik
J
,
Rome
JJ
,
Collins
MH
,
DeCampli
WM
,
Spray
TL
.
The hypoplastic left heart syndrome with intact atrial septum: atrial morphology, pulmonary vascular histopathology and outcome
.
J Am Coll Cardiol
.
1999
;
34
(
2
):
554
60
.
3.
Arai
S
,
Fujii
Y
,
Kotani
Y
,
Kuroko
Y
,
Kasahara
S
,
Sano
S
.
Surgical outcome of hypoplastic left heart syndrome with intact atrial septum
.
Asian Cardiovasc Thorac Ann
.
2015
;
23
(
9
):
1034
8
.
4.
Sathanandam
SK
,
Philip
R
,
Gamboa
D
,
Van Bergen
A
,
Ilbawi
MN
,
Knott-Craig
C
, et al
.
Management of hypoplastic left heart syndrome with intact atrial septum: a two-centre experience
.
Cardiol Young
.
2016
;
26
(
6
):
1072
81
.
5.
Chaturvedi
RR
,
Ryan
G
,
Seed
M
,
van Arsdell
G
,
Jaeggi
ET
.
Fetal stenting of the atrial septum: technique and initial results in cardiac lesions with left atrial hypertension
.
Int J Cardiol
.
2013
;
168
(
3
):
2029
36
.
6.
Schmidt
M
,
Jaeggi
E
,
Ryan
G
,
Hyldebrandt
J
,
Lilly
J
,
Peirone
A
, et al
.
Percutaneous ultrasound-guided stenting of the atrial septum in fetal sheep
.
Ultrasound Obstet Gynecol
.
2008
;
32
(
7
):
923
8
.
7.
Szwast
A
,
Tian
Z
,
McCann
M
,
Donaghue
D
,
Rychik
J
.
Vasoreactive response to maternal hyperoxygenation in the fetus with hypoplastic left heart syndrome
.
Circ Cardiovasc Imaging
.
2010
;
3
(
2
):
172
8
.
8.
Mustafa
HJ
,
Aghajani
F
,
Jawwad
M
,
Shah
N
,
Abuhamad
A
,
Khalil
A
.
Fetal cardiac intervention in hypoplastic left heart syndrome with intact or restrictive atrial septum, systematic review, and meta-analysis
.
Prenat Diagn
.
2024
;
44
(
6–7
):
747
57
.
You do not currently have access to this content.