Fetal cardiac intervention and surgery.

Fetal echocardiography has changed our understanding of congenital heart disease by allowing us to diagnose and observe the malformed human heart within weeks of primary morphogenesis. Serial echocardiographic studies have shown that some complex heart malformations result from relatively simple primary lesions that occur early during heart development and may be amenable to an in utero intervention aimed at altering abnormal growth patterns. Although fetal cardiac intervention or surgery does not presently exist as a realistic therapeutic option in the management of critical congenital heart disease, progress in several areas of investigation give merit to the concept and future potential of in utero cardiac repair.