Over the past 30 years, with the development of diagnostic and therapeutic techniques and the formation of multidisciplinary teams, the safety and efficacy of fetal cardiac intervention (FCI) have been increasingly recognised by fetal medicine and fetal cardiologists, and it has been carried out in many children’s heart centres around the world. More and more evidence shows that FCI can optimise ventricular haemodynamics, prevent ventricular dysplasia, promote the establishment of biventricular circulation, help alleviate or change the course of the disease, and can be used as a treatment method to save ventricular and great vessel development. This article reviews the history and current status, mechanism of action, surgical indications, and clinical outcomes of FCI for treating CHD in fetuses. It also analyses the development opportunities and challenges of FCI and proposes constructive suggestions for future research directions and improvement measures, with the aim of providing a reference basis for the in-depth development of this field.

Fetuses with critical aortic stenosis, severe mitral regurgitation and left atrial enlargement are at risk to develop heart failure and intrauterine death. We present two cases with this physiology who underwent fetal aortic balloon valvuloplasty at 25 + 5 and 28 + 2 weeks as their only intervention without requiring postnatal treatment during short- to medium-term follow-up of 1.4 and 4.9 years.