Long-term fetal outcome after fetal cardiac bypass: Fetal survival to full term and organ abnormalities

Abstract

This study demonstrates that with improvements in fetal extracorporeal circuitry and techniques very favorable fetal outcome can be achieved. Further studies are necessary to evaluate the effects of bypass on fetal brain in an appropriate animal model. Advances in extracorporeal circuitry to suit the unique fetal physiology increase the possibility of future clinical application.

Myocardial function after fetal cardiac bypass in an ovine model

“…Many of these technical challenges have been studied and at least partially overcome,5 but successful clinical translation has yet to be achieved. The ability to perform intra-cardiac procedures depends upon understanding the mechanisms leading to cardiac dysfunction and eventually developing methods to protect the fetal myocardium.…”

Operative techniques and strategies for minimally invasive fetoscopic fetal cardiac interventions in sheep

“…Fetal cardiac bypass, pacemaker implantation, and cryosurgical atrioventricular nodal ablation are all feasible in fetal sheep [3,7,9,22,26,27]. Unfortunately, even though they are technically straightforward, open fetal cardiac surgical approaches are associated with significant maternal and fetal morbidity, because fetal cardiac access requires maternal laparotomy and hysterotomy as well as fetal thoracotomy.…”

Intrauterine Therapie bei fetalen Herzfehlern

“…Die of fe ne Fe tal chir ur gie könn te die tech ni sche Er folgs ra te von fe ta len Val voto mi en so wie Schritt ma che rim plan ta tionen we sent lich er hö hen und auch Ein griffe am fe ta len Her zen er mög li chen, die mittels per ku ta nen ul tra schall ge steu er ten oder fe to sko pi schen Tech ni ken nicht durch führ-bar sind. Grund le gen de Tech ni ken, wie fe to pla zen ta rer By pass, Schritt ma che rimplan ta ti on und kryo chir ur gi sche Atrio ventri ku lar kno tena b la ti on konn ten an schwange ren Scha fen ent wi ckelt wer den ( [19,20,21,22,53,54,59]; . Abb.…”