Left Ventricular Outflow Occlusion: An Alternative Approach to Late Selective Fetal Termination in Monochorionic Twin Gestations

We report the case of a monochorionic twin gestation discordant for mutation in chromodomain-helicase-DNA-binding protein 7 (CHD7) gene and cerebral abnormalities consequent to an early devastating cerebrovascular event. The parents elected selective termination given poor prognosis this fetus, but socio-economic considerations wished defer procedure as late possible, despite awareness risks limitations existing techniques at end pregnancy. A novel technique was used achieve feticide late-preterm period. An endovascular balloon catheter occlude left ventricular outflow coronary circulations resulting fetal asystole while also arresting fetoplacental flow immediately prior delivery healthy fetus.