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

The Journal of Thoracic and Cardiovascular Surgery
V M ReddyF L Hanley

Abstract

Earlier work suggests that fetal cardiac bypass is technically feasible but results in significant placental dysfunction. Many of the stimuli that initiate this placental dysfunction have been identified in the past several years and these involve fetal stress, extracorporeal surfaces, priming substances (maternal blood), and flow characteristics. Fetal survival with conventional methods of bypass has been far less than optimal. A novel fetal bypass circuit requiring no priming volume was designed incorporating an in-line axial flow pump (Hemopump, Johnson & Johnson Interventional Systems, Rancho Cordova, Calif.) and was demonstrated to have a marked beneficial effect on placental function. The purpose of this study was to investigate the effect of this newly developed customized fetal bypass circuit on fetal survival and developing fetal organs. Nine fetuses at 122 to 126 days of gestation were subjected to fetal cardiac bypass via a transsternal approach, with a 16F single right atrial venous cannula and a 12F arterial cannula. Normothermic cardiac bypass was continued for 30 minutes at flow rates of 320 +/- 32 ml/kg. Of the nine fetuses, one fetus was stillborn 4 days after bypass and eight (89%) were delivered alive after p...Continue Reading

References

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Citations

Apr 12, 2008·World Journal of Pediatrics : WJP·Zhao-Kang Su, En Chen
Sep 2, 2000·The Annals of Thoracic Surgery·A J ParryF L Hanley
May 5, 2001·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Y TannirandornD Charoenvidhya
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Jul 26, 2011·The Journal of Thoracic and Cardiovascular Surgery·Xiao-bing LiuJian Zhuang
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Sep 27, 2005·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·L E Wilkins-HaugJ E Lock
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