Tu Du Hospital, in collaboration with Children’s Hospital 1 in Ho Chi Minh City, has successfully performed Vietnam’s first Ministry of Health-approved fetal cardiac intervention on a fetus diagnosed with severe pulmonary valve stenosis.

On December 31, Tu Du Hospital announced that a team of more than 25 specialists had completed the groundbreaking fetal balloon valvuloplasty in just over 30 minutes - marking the first officially licensed case of its kind in the country.

The patient, N.T.T.T, a 26-year-old woman from Ho Chi Minh City, was in her second pregnancy. Early prenatal screenings, including first-trimester ultrasounds and NIPT tests, showed no abnormalities.

However, between weeks 22 and 24, a detailed fetal echocardiogram revealed that the fetus had severe pulmonary valve stenosis accompanied by tricuspid regurgitation.

She was immediately referred for multidisciplinary consultations at Tu Du Hospital and Children’s Hospital 1. Amniocentesis results showed a normal chromosome profile, a key factor supporting the decision to proceed with fetal intervention.

By week 29, the condition worsened, with signs of progressive right ventricular hypoplasia. Without timely intervention, the fetus was at high risk of developing single ventricle physiology after birth - a severe form of congenital heart disease with poor long-term outcomes.

On December 29, a joint hospital board convened and confirmed a diagnosis of severe pulmonary valve stenosis progressing to valve atresia. The team unanimously decided on an emergency in utero balloon valvuloplasty via transabdominal access.

The procedure was carried out on the morning of December 30. Despite the fetus presenting in a head-down, left-facing position with anterior placenta - which increased the complexity - surgeons overcame several technical challenges.

In particular, the fetus’s arm was positioned across its chest, obscuring access to the heart. The team skillfully performed fetal repositioning maneuvers to safely reach the targeted site.

The team successfully inserted a needle through the mother’s abdomen, uterus, fetus’s chest wall, and into the right ventricle, using a balloon to dilate the pulmonary valve.

Amazingly, the procedure succeeded on the first attempt, minimizing time and risk to both mother and fetus.

According to doctors, the intervention aimed to improve blood flow through the pulmonary valve, allowing the right ventricle to develop more fully during the remainder of gestation.

This increases the chances of preserving a biventricular (or 1.5-ventricle) circulation after birth, avoiding the need for complex and prolonged single-ventricle surgical pathways.

Dr. Tran Ngoc Hai, Director of Tu Du Hospital, confirmed that this was the 12th fetal heart intervention performed by the hospital - but the first one conducted under formal Ministry of Health approval.

Previously, the hospital had conducted several successful cases, but the technique was still awaiting official recognition.

Now, the Ministry of Health has officially added fetal cardiac interventions to its list of approved medical procedures, authorizing both Tu Du Hospital and Children’s Hospital 1 to perform them.

"With official approval, the cost of the procedure has been standardized to match the affordability of Vietnamese families,” Dr. Hai said. “It’s more expensive than adult cardiac procedures but still covered by national health insurance to ensure accessibility for all.”

After the procedure, the patient will be closely monitored until delivery. Depending on the evolving condition of the fetus and mother, doctors will recommend the most suitable care and delivery method.

Experts stress that the first trimester is the golden window for detecting fetal anomalies, especially cardiac conditions. Pregnant women are strongly advised to attend regular prenatal checkups and undergo specialized fetal echocardiograms when indicated.

Phuoc Sang