Fetal cardiac intervention

Improved results of fetal cardiac bypass in immature fetuses using the TinyPump device

Vinod A. Sebastian, Giuseppe Ferro, Hiroshi Kagawa, Teimour Nasirov, Katsuhide Maeda, William T. Ferrier, Setsuo Takatani, R. Kirk Riemer, Frank L. Hanley, V. Mohan Reddy

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: Fetal cardiac surgery is a potential innovative treatment for certain congenital heart defects that have significant mortality and morbidity in utero or after birth, but it has been limited by placental dysfunction after fetal cardiac bypass. We have used the TinyPump device for fetal cardiac bypass in sheep fetuses at 90 to 110 days gestation. Methods: Ten mixed-breed pregnant ewes were used over a period of 6 months, and 10 fetuses were placed on bypass for 30 minutes. Five fetuses with a mean gestational age of 104 ± 4.5 days and mean weight of 1.4 ± 0.4 kg were placed on bypass using the TinyPump device, and 5 fetuses with a mean gestational age of 119 ± 4.5 days and mean weight of 3.4 ± 0.4 kg were placed on bypass using the roller head pump. The fetuses were monitored for up to 3 hours after bypass or until earlier demise. Results: Progressive respiratory and metabolic acidosis developed in all fetuses. The TinyPump group had a lower gestational age and weight compared with the roller head pump group. However, the rate of postbypass deterioration in the TinyPump group, as measured with blood gases, was noted to be significantly slower compared with the roller head pump group. Conclusions: We demonstrate the feasibility of the TinyPump device for fetal cardiac bypass in a fetal sheep model. The TinyPump group showed improved results compared with the roller head group despite more immature fetuses. The TinyPump device seems to be a promising device for future studies of fetal cardiac bypass in immature fetal sheep and in primates.

Original languageEnglish (US)
Pages (from-to)1460-1464
Number of pages5
JournalJournal of Thoracic and Cardiovascular Surgery
Volume145
Issue number6
DOIs
StatePublished - Jun 2013

Fingerprint

Fetus
Equipment and Supplies
Gestational Age
Sheep
Head
Weights and Measures
Respiratory Acidosis
Congenital Heart Defects
Acidosis
Primates
Thoracic Surgery
Gases
Parturition
Morbidity
Pregnancy
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Fetal cardiac intervention : Improved results of fetal cardiac bypass in immature fetuses using the TinyPump device. / Sebastian, Vinod A.; Ferro, Giuseppe; Kagawa, Hiroshi; Nasirov, Teimour; Maeda, Katsuhide; Ferrier, William T.; Takatani, Setsuo; Riemer, R. Kirk; Hanley, Frank L.; Reddy, V. Mohan.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 145, No. 6, 06.2013, p. 1460-1464.

Research output: Contribution to journalArticle

Sebastian, VA, Ferro, G, Kagawa, H, Nasirov, T, Maeda, K, Ferrier, WT, Takatani, S, Riemer, RK, Hanley, FL & Reddy, VM 2013, 'Fetal cardiac intervention: Improved results of fetal cardiac bypass in immature fetuses using the TinyPump device', Journal of Thoracic and Cardiovascular Surgery, vol. 145, no. 6, pp. 1460-1464. https://doi.org/10.1016/j.jtcvs.2012.08.014
Sebastian, Vinod A. ; Ferro, Giuseppe ; Kagawa, Hiroshi ; Nasirov, Teimour ; Maeda, Katsuhide ; Ferrier, William T. ; Takatani, Setsuo ; Riemer, R. Kirk ; Hanley, Frank L. ; Reddy, V. Mohan. / Fetal cardiac intervention : Improved results of fetal cardiac bypass in immature fetuses using the TinyPump device. In: Journal of Thoracic and Cardiovascular Surgery. 2013 ; Vol. 145, No. 6. pp. 1460-1464.
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