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F122Fetal cardiology considering fetal intervention, and animal model of fetal pacing and fetal cariopulmonary bypass
Author(s) -
Chiba Y.,
Kawamata K.,
Bando K.,
Kawahira Y.
Publication year - 2000
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2000.00015-1-121.x
Subject(s) - medicine , fetus , pulmonary atresia , hypoplastic left heart syndrome , stenosis , cardiology , premature atrial contraction , heart block , fetal echocardiography , tricuspid atresia , heart disease , surgery , pregnancy , prenatal diagnosis , electrocardiography , atrial fibrillation , genetics , biology
Background Two hundred two cases of structural heart diseases were diagnosed prenatally, and 23 cases of complete AV block were delivered. However, their mortality has not been decreased. We have to discuss the possibility of fetal interventions for heart diseases. Methods The mortality of fetal heart diseases diagnosed prenatally were discussed. Resent new findings of fetal cardiology considering fetal mortality and the possibility of fetal interventions were discussed. Animal experiments for fetal cardiac interventions were performed. Results The total mortality of fetal structural heart diseases was 60.2%. The mortality of hydropic heart diseases was 92%. The mortality of hypoplastic left heart syndrome was 100%, that of Ebstein's anomaly was 88%, and that of pulmonary valve atresia or stenosis was 64%. The total mortality of complete AV block was 30.4%. That of hydropic complete AV block was 50%. Fifteen cases of complete AV block were performed implantation of pacemaker after birth. The youngest case was 32 weeks delivered, the birth weight of which was 1906g. The procedure of fetal intervention should be simple. They will be aortic valvotomy, pulmonary valvotomy, enlargement of foramen ovale, and fetal pacing. Considering fetal or neonatal interventions for pulmonary atresia or critical stenosis, the findings of sinusoidal communication is essential. According to the good resolution of ultrasonic equipment, details of sinusoidal communication can be diagnosed. We have started group study to select cases to be considered cardiac interventions for fetuses and to develop surgical technique by support of japanese ministry of health and Welfare. We performed the implantation of pacemaker to fetal ram and experiments of fetal cardiopulmonary bypass.