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Conditions We Treat

Fetal Heart Defects

A congenital heart defect or congenital heart disease means your baby’s heart or their heart’s blood vessels are not growing the typical way before birth. Special fetal cardiac care can find and sometimes treat heart defects before your baby is born.

What Is a Fetal Heart (Cardiac) Defect?

A heart defect is when the heart or the heart’s blood vessels do not grow (develop) the right way before birth. The words “congenital heart defect” and “congenital heart disease” both mean that the defect happened before the baby was born. The Centers for Disease Control and Prevention (CDC) estimates that nearly 1% of births each year in the United States (or about 40,000 babies) are affected by congenital heart defects. Having the right specialists to diagnose and treat these conditions in a timely manner is critical.

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How Are Fetal Heart (Cardiac) Conditions Diagnosed?

Many heart (cardiac) abnormalities can now be accurately diagnosed before birth through a few types of tests completed during pregnancy. In most cases, early diagnosis of heart defects leads to better outcomes and long-term management after your baby is born. These tests can show details of the heart condition or defects including whether it is a structural defect, functional defect, or a problem with the heartbeat.

If you are pregnant, your doctor may recommend testing, such as:

  • Fetal echocardiogram: A specialized ultrasound to look at your baby’s heart.

In addition, to look for other anomalies, your doctor may recommend other tests such as:

  • Comprehensive Ultrasound: A high-resolution 3D ultrasound to confirm the diagnosis and look for other concerns.
  • Fetal MRI (magnetic resonance imaging): Imaging that gives more detailed pictures than what is seen on ultrasound. If your OB or MFM saw any concerns with your baby’s organs, a fetal MRI shows more detail of any abnormalities in the fetal organs that are not visible on an ultrasound.

What Are the Treatment Options for Fetal Heart (Cardiac) Conditions?

Treatment options for fetal heart conditions will vary depending on the specific diagnosis. Some factors can include the type of fetal heart defect and how complex or severe the defect is. Many times, treatment for the heart defect is better when done after birth. However, in some cases early treatment, while the baby is still in the womb, results in the heart growing stronger, and can improve outcomes after birth.

Fetal Heart (Cardiac) Interventions

In some cases, fetal cardiac intervention may be an option. Fetal cardiac intervention is a procedure to repair your child's heart defect while they are still in the womb. This is to prevent or lessen the impact of certain cardiac defects before the baby is born (in utero). Nationwide Children’s is one of only a few programs in the country that offers this type of care.

Fetal heart procedures our specially trained team performs include:

  • Fetal aortic balloon valvuloplasty: : The goal of this procedure is to open the narrowed (stenotic) aortic valve before the left ventricle can shrink or is forced to stop growing. Opening this valve may improve blood flow in and out of the left ventricle and allow it to keep growing during pregnancy. If normal blood flow can be restored, the baby may have a normal-sized, functioning left ventricle at birth.
  • Fetal atrial septostomy or fetal atrial septal stent: : The goal of this surgery is to open the blocked atrial septum with a balloon and/or stent before damage is done to the baby’s lungs. Opening the blocked septum and restoring normal blood flow can decrease pressure in the left atrium, giving the lungs time to heal before birth. This procedure may be done for a heart defect called hypoplastic left heart syndrome (HLHS). The surgeries for HLHS are still needed after birth.
  • Fetal pulmonary balloon valvuloplasty: : The goal of this procedure is to open the narrowed pulmonary valve. When the pulmonary valve becomes narrow, it restricts blood flow from the right ventricle to the lungs. Opening this valve may improve blood flow in and out of the right ventricle to help babies with a heart condition called pulmonary stenosis.

Treatment Options After Birth

Sometimes, even if your doctor finds that your unborn baby has a heart condition, cardiac intervention is not needed before birth. In those cases, our team offers advanced testing and monitoring throughout your pregnancy and helps create a plan for your baby’s care after birth. Once your baby is born, they will receive care from The Heart Center. This will include long-term monitoring of your baby’s condition or any procedures your baby may need. Our surgeons are known for their treatment of complex, high-risk patients. Our surgical outcomes continue to be better than the national average.

The Heart Center at Nationwide Children’s is currently ranked #5 in the country for Cardiology and Heart Surgery and top ranked in Midwest. There are many components and teams within our program that contribute to our successful outcomes.

  • The Single Ventricle Program helps children and families cope with the challenges of a single ventricle diagnosis and improve outcomes. Approximately 1,000 children are born each year with a single ventricle heart defect, in which one lower chamber of the heart is either underdeveloped, too small or missing a valve.
  • Interventional Cardiology is an internationally recognized program that provides a full spectrum of diagnostic and interventional cardiac catheterization procedures. State-of-the-art technology includes two custom-built Hybrid Cardiac Catheterization Suites and a Hybrid Operating Suite equipped to provide for the interventional treatment of all patients with congenital and acquired heart disease.
  • Dedicated cardiothoracic intensive care unit (CTICU) and separate cardiac step-down unit are staffed 24 hours a day, 7 days a week
  • From minimally invasive heart surgery to open heart surgery, the cardiothoracic surgeons at Nationwide Children’s use a variety of surgical techniques to repair congenital and acquired heart defects ranging from the most straightforward to the extremely complex.

Speak With Our Team

Learning that your unborn baby has or might have a heart condition can be very overwhelming. The Fetal Center heart specialists, surgeons and nurses are here to help you find the best care for you and your baby. The first step is connecting with the team to learn more about your baby’s condition and how the team can best help you. Every case is unique.

The Fetal Center team provides second opinions to educate and support parents as they learn more about their treatment options. Second opinions may offer additional information or insight into their best option both during pregnancy and after birth.

 

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