HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kohl, T. Articles by Rickert, C. H. Search for Related Content PubMed PubMed Citation Articles by Kohl, T. Articles by Rickert, C. H. Related Collections Minimally invasive surgery

J Thorac Cardiovasc Surg 2004;128:467-471
© 2004 The American Association for Thoracic Surgery

Surgery for congenital heart disease

Amniotic air insufflation during minimally invasive fetoscopic fetal cardiac interventions is safe for the fetal brain in sheep

^a Division of Obstetrics & Prenatal Medicine, University Hospital of Bonn, Bonn, Germany
^b Department of Pediatric Cardiology, Münster University Children's Hospital, Münster, Germany
^c Department of Anesthesiology & Perioperative Intensive Care, Münster University Hospital, Münster, Germany
^d Department of Thoracic & Cardiovascular Surgery, Münster University Hospital, Münster, Germany
^e Institute of Neuropathology, Münster University Hospital, Münster, Germany
^f Institute of Pathology, Münster University Hospital, Münster, Germany

Received for publication November 24, 2003; revisions received December 30, 2003; revisions received January 12, 2004; accepted for publication January 28, 2004.

^* Address for reprints: Thomas Kohl, MD, German Center for Fetal Surgery, Department of Obstetrics & Prenatal Medicine, University of Bonn Medical School, 53105 Bonn, Germany
thokohl{at}t-online.de

BACKGROUND: Amniotic air insufflation during experimental fetoscopic fetal cardiac interventions greatly improves the visualization of intra-amniotic contents. The purpose of this study was to assess any histologically discernible effects from this approach on the fetal brain after short-term studies and long-term survival in sheep.

METHODS: Thirty pregnant ewes between 80 and 110 days of gestation underwent amniotic air insufflation during various fetoscopic fetal cardiac interventions. After 18 short-term and 12 long-term studies, the brains of the operated fetuses and—if available—their unoperated siblings were examined for hemorrhage, embolism, infarctions, inflammatory changes, and abnormal cortical maturation.

RESULTS: Amniotic air insufflation during minimally invasive fetoscopic fetal cardiac interventions did not result in any histologically discernible damage to the brain in short-term and long-term studies in any but 2 sibling sheep. In the 2 affected siblings, a small area of chronic cortical frontal lobe infarction was observed after long-term survival.

CONCLUSIONS: Amniotic air insufflation during minimally invasive percutaneous fetoscopic fetal cardiac interventions is safe for the fetal brain and does not compromise maternal hemodynamics in sheep. These findings encourage further investigation of the role this technique might play during fetoscopic fetal cardiac interventions in humans.

This article has been cited by other articles:

				T. Kohl, J. Breuer, A. Heep, I. Wenningmann, J. Weinbach, and U. Gembruch Fetal transesophageal echocardiography during balloon valvuloplasty for severe aortic valve stenosis at 28+6 weeks of gestation J. Thorac. Cardiovasc. Surg., July 1, 2007; 134(1): 256 - 257. [Full Text] [PDF]