Fetal Surgery May Treat Heart Defect(o the aorta and then into the body McElh...),Health

Over seven years, the researchers were able to establish criteria to determine which infants were likely to benefit from the procedure, which would not and when the operation would be most likely to succeed, McElhinney said. "This enables us to focus it more, and expose fewer mothers and fetuses to the risks of the procedure," he said.

The window for performing the procedure is narrow -- at around 20 to 21 weeks of pregnancy, McElhinney said. With time, experience and better technology, the success rate will get better, he added.

McElhinney is cautious about the impact of the new procedure and doesn't want to oversell its benefits.

"By no means is this revolutionizing the care for all fetuses with hypoplastic left heart syndrome," he said. "It's applicable only in a small subset of those with this disease, and it's working in a relatively small percentage of those in whom we attempt it," he said. And even infants who had a successful procedure needed additional procedures after birth, he noted.

Still, while not a "ringing success," he said it reinforces the belief that prenatal intervention can be used to change the development of serious forms of heart disease.

Dr. Steven E. Lipshultz, chairman of pediatrics at the Leonard M. Miller School of Medicine at the University of Miami, said that the study points the way to better treatment and outcomes for youngsters with this heart problem.

"This is a landmark study," Lipshultz said. Without this procedure, "every one of these kids would have needed open heart surgery in the first few days after birth," he said. Additional surgeries and multiple heart transplants are almost always necessary, he added.

Parents whose doctors think their baby might have hypoplastic left heart syndrome should act fast to find a program that will consider their child for a fetal operation, he said.