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Fetal surgery for congenital heart disease

Authors
 Han Ki Park  ;  Young Hwan Park 
Citation
 Yonsei Medical Journal, Vol.42(6) : 686-694, 2001 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2001
MeSH
Animals ; Cardiac Surgical Procedures ; Female ; Fetoscopy ; Fetus/surgery* ; Heart Defects, Congenital/surgery* ; Humans ; Pediatrics/methods ; Pregnancy
Keywords
Fetal surgery ; congenital heart disease
Abstract
Certain congenital heart defects, which present at birth as complex morphologic defects, are actually the result of a relatively simple primary lesion and the subsequent acquired development of a complex secondary lesion during gestation. Moreover, fetal heart approach during gestation can prevent simple cardiac lesions from such development. Specific structural lesions can be diagnosed before 12 weeks of gestation by transvaginal fetal echocardiography, and animal experiments have shown that direct or indirect fetal cardiac approach and fetal cardiac bypass are technically feasible. A number of fetal bypass models have resulted in long-term survivors, with for example, the delivery of normal lambs at full-term gestation. Also, successful full-term delivery has been obtained after fetal cardiac intervention. The success of fetal cardiac bypass was accomplished by the use of total spinal anesthesia and the administration of indomethacin. Moreover, a 42% long-term survival after fetal cardiopulmonary bypass in a fetal lamb model has been reported. Maternal risk related to fetal bypass should be considered carefully alongside fetal risks and benefits. Most fetal malformations do not directly threaten maternal health, yet the procedures required to address fetal malformations can produce significant maternal risk and discomfort and subsequent pregnancies may be jeopardized. Further investigation of maternal outcome is required. Deep exploration of fetal and maternal pathophysiologic responses to intervention and comprehensive investigation is required to overcome current limitations, and should precede clinical trials as many problems remain to be solved before these techniques can be applied to human beings.
Files in This Item:
T200103386.pdf Download
DOI
10.3349/ymj.2001.42.6.686
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Young Hwan(박영환)
Park, Han Ki(박한기) ORCID logo https://orcid.org/0000-0002-7472-7822
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/142942
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