Maternal-Fetal Interactions in Fetal Cardiac Surgery

Fetal trans-apical stent delivery into the pulmonary artery: prospects for prenatal heart-valve implantation

“…While several experimental studies have also addressed the feasibility of using fetal cardiac bypass [22,23], open-fetal-cardiac surgery for valvotomy has not yet been successfully achieved. Although allowing for a definite repair of the structural defect, fetal loss following fetal open-heart interventions has been reported [1].…”

Application of Near-Infrared Spectroscopy During Fetal Cardiac Surgery

“…Based on our previous studies, we aimed for a target flow rate of 200-250 mL/min/kg [4,[19][20][21][22]. Our pump system is normothermic and nonpulsatile, consisting of a roller pump (SARNS 7000; Ann Arbor, MI), with vacuum assisted venous drainage (Jostra-VAVD controller; Maquet, Sundbyberg, Sweden), and a heat exchanger, (CSC-14; Cobe Cardiovascular, Arvada, CO) [19][20][21][22].…”

“…Using methods previously described, fetal bypass was performed after jugular vein cannulation using a 10F or 12 F Bio-Medicus cannula (Medtronic, Minneapolis, MN), and carotid artery cannulation using a 6F or 8F Bio-Medicus cannula [4,[19][20][21][22]. Based on our previous studies, we aimed for a target flow rate of 200-250 mL/min/kg [4,[19][20][21][22].…”

“…Lastly, an umbilical flow probe was placed on the common umbilical artery (Transonic Systems, Ithaca, NY) to measure placental blood flow. Hemodynamic values were continuously recorded throughout the procedure using a PowerLab data acquisition system (AD Instruments, Colorado Springs, CO) as previously described [4,[19][20][21][22]. All procedures were performed in accordance with Institutional Animal Care and Use Committee-approved procedures in an Association for Assessment and Accreditation of Laboratory Animal Care-approved facility.…”

“…A disruption of oxygen transfer from mother to fetus can lead to fetal distress and possible fetal demise if not rectified [1][2][3]. During fetal surgery, the fetus is placed under tremendous stress resulting in a number of pathophysiologic responses, including a decrease in cardiac output and placental blood flow resulting in decreased oxygen delivery, and possible placental dysfunction [4,5].…”