Keeping abreast of advances in fetal cardiology.

Advances in genetics and computing have contributed to a better understanding of the mechanisms underlying cardiovascular development, its programming and possible therapeutic manipulation. Pre-conceptual folate can reduce the prevalence of cardiac malformations and improvements in imaging allow us to detect congenital heart disease and assess function at earlier gestations. Three- and four-dimensional imaging may improve the surgeons' understanding of complex vascular malformations as well as permitting remote diagnosis. Treatment of fetal arrhythmias may be rationalised by fetal electrocardiography and magnetocardiography and by further defining the natural history of complete heart block and mechanisms of tachyarrhythmia. Tissue engineering and robotics may improve the surgical outcome for children by creating conduits with growth potential thus reducing the need for multiple surgical procedures. These technologies may permit successful fetal surgical procedures. Cross discipline collaboration has been key in enabling these advances which have changed the face of fetal cardiology.