Iris Scharnreitner, Julian Hochpöchler, Felix Mögel, Florian Putre, Judith Rittenschober-Böhm, Georg Grüßenberger, Simona Anna Marcora, Peter Oppelt, Gerald Tulzer, Andreas Tulzer
Kepler University Hospital and Johannes Kepler University Linz. ASST Grande Ospedale Metropolitano Niguarda.
Austria and Italy
Journal of the American College of Cardiology Case Reports
JACC Case Rep 2026;
DOI: 10.1016/j.jaccas.2026.108155
Abstract
Background: In utero stenting of the atrial septum has been introduced for fetuses with hypoplastic left heart syndrome (HLHS) and intact atrial septum (IAS) to prevent secondary pulmonary vascular damage caused by left atrial hypertension. Previous reports revealed a high risk of significant or complete in-stent obstruction after successful intervention due to endothelial proliferation.
Case summary: We report a fetus with HLHS and IAS complicated by nutmeg lung who underwent successful fetal atrial septal stenting using an everolimus-eluting stent (Xience Sierra; Abbott). The procedure resulted in immediate left atrial decompression and maintained an unrestrictive interatrial communication until delivery.
Discussion: The use of a drug-eluting stent resulted in sustained stent patency without evidence of endothelial overgrowth and without detectable systemic adverse effects in the fetus.
Take-home message: In utero use of an everolimus-eluting stent appears safe and may reduce the risk of in-stent obstruction in fetuses with HLHS and IAS.
Category
Class II. Pulmonary Hypertension Associated with Valvular Disease of the Left Side of the Heart
Surgical and Catheter-mediated Interventions for Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes