on doctors Rainbow Children’s Heart InstituteHyderabad, achieved an unprecedented medical milestone by performing life-saving fetal balloon aortic valvuloplasty on a 27-week-old fetus. The procedure addressed critical aortic stenosis, a severe narrowing of the aortic valve, which could be fatal to the fetus. What sets this achievement apart is the pioneering use of a closure device to seal the puncture site – a global first in fetal heart care.

The intervention was led by Dr. Koneti Nageswara Rao, Chief Pediatric Cardiologist, along with Dr. Shweta Bakhru and Dr. Sri Phani Bhargavi Dhulipudi, along with fetal medicine specialists, pediatric cardiologists, obstetricians and interventional cardiologists. There was collaboration of a multidisciplinary team. Advanced imaging revealed that the fetal aortic valve was severely narrowed, affecting heart function and threatening survival.

Under ultrasound guidance, the team used a needle to pass through the mother’s abdomen and uterus to reach the fetal heart. A balloon catheter was then inserted into the aortic valve to remove the blockage and restore blood flow. Unlike traditional methods, this procedure used a larger needle and balloon due to complications including blood leakage from the heart. The team introduced a closure device to seal the puncture site to ensure the safety of the fetus during and after the procedure.

Fetal aortic stenosis can lead to hypoplastic left heart syndrome or even fetal death. Fetal balloon aortic valvuloplasty, a high-risk but potentially life-saving procedure, usually has a success rate of about 70 percent. However, using the closure device in this context is a first-of-its-kind approach, setting a new standard in fetal cardiac interventions.

This process was resoundingly successful. A significant improvement in fetal heart function was observed and after a healthy delivery, the baby was carefully monitored. The baby has been discharged in good health, a milestone in fetal cardiology.

The child will remain under regular follow-up care, allowing doctors to monitor heart function and address any recurring blockages through additional interventions such as balloon dilatation. Most babies who undergo this procedure grow well and reach positive developmental milestones.

This achievement demonstrates the potential of advanced technologies to treat conditions previously thought untreatable in utero. Dr Koneti Nageswara Rao commented, “This success highlights our commitment to pushing the boundaries of fetal medicine. The innovative use of the closure device shows how teamwork and technology can save lives even before birth.

This effort opens new doors for families facing serious fetal heart problems, providing hope and demonstrating the potential of medical innovation to improve outcomes. With continued advances in fetal medicine, more lives can be saved even before birth.

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