The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on percutaneous fetal balloon valvuloplasty for pulmonary atresia with intact ventricular septum.

In accordance with the Interventional Procedures Programme process guide, guidance on procedures with special arrangements are reviewed 3 years after publication and the procedure is reassessed if important new evidence is available.

The guidance was considered for reassessment in January 2013 and it was concluded that NICE will not be updating this guidance at this stage. However, if you believe there is new evidence which should warrant a review of our guidance, please contact us via the email address below.


Congenital heart defects are the most common type of birth defect and include critical pulmonary stenosis and pulmonary atresia with intact ventricular septum (PAIVS).

Pulmonary stenosis in utero is usually mild and typically does not adversely affect the pregnancy. However the more severe lesion of pumonary atresia with intact ventricular septum has a high rate of postnatal morbidity and mortality.

Percutaneous fetal balloon valvuloplasty is performed at 21–32 weeks' gestation under maternal local anaesthesia and sedation using ultrasound guidance.

Coding recommendations


SNOMED CT preferred term (concept ID)

Ultrasonography guided percutaneous balloon valvuloplasty of aortic valve of fetus (819671000000105)


R04.8 Other specified therapeutic percutaneous operations on fetus

Y40.3 Balloon dilation of organ NOC

A code from category Y95.- Gestational age must be assigned in a subsidiary position where this information is available.

Y53.2 Approach to organ under ultrasonic control

Z32.4 Pulmonary valve

Diagnosis or health condition

SNOMED CT preferred term (concept ID)

Pulmonary atresia with intact ventricular septum (253590009)