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Computer-Aided Automatic Delivery System of High-Intensity Focused Ultrasound for Creation of an Atrial Septal Defect

Several fetal cardiac malformations have been increasingly treated before birth. Fetal cardiac intervention targets an in utero correction of simple intracardiac abnormalities that potentially progress to complex heart diseases in utero, such as fetal critical aortic stenosis that might cause to hypoplastic left heart syndrome (HLHS) and HLHS with restrictive atrial septum leading to irreversible pulmonary vascular damages (Kohl et al., 2000; Marshall et al., 2004; Makikallio et al., 2006). Current operative procedures for correction of fetal restrictive atrial septum with an atrial decompression are still invasive because they, percutaneously and through both the uterine wall and fetal chest walls, require ultrasoundguided maternal puncture into the frequently-pulsating (120-180 counts per minute) cardiac cavity of tiny fetal hearts and to create interatrial communications. Accordingly, these procedures have been reportedly accompanied by serious complications including profound bradycardia, bleeding and hemopericardium, intracardiac thrombus formation, and recurrent in utero closure of the created atrial septal defects.