Application of echocardiography in fetal cardiac intervention of pulmonary atresia with intact ventricular septum

doi:10.3877/cma.j.issn.1672-6448.2023.06.006

Abstract

Abstract:

Objective

To summarize our experience with the application of echocardiography in fetal cardiac intervention (FCI) and improve the success rate of FCI.

Methods

From July 2018 to May 2019, 12 fetuses were diagnosed with pulmonary atresia with intact ventricular septum (PA/IVS) with right heart dysplasia and treated at the Women and Children's Hospital, Qingdao University. The median gestational age was 27 (26-28) weeks. All fetuses underwent FCI under the guidance of echocardiography. Our experience with the application of perioperative echocardiography in FCI was then summarized.

Results

All fetuses in this study underwent FCI successfully, with an average operation time of 5.3±1.11 min. Bradycardia occurred immediately after FCI in 5 fetuses, which needed to be treated with epinephrine or atropine in the right atrium. A small amount of pericardial hematocele can be absorbed by the fetus in the early stage after FCI. One mother each chose to terminate pregnancy due to heart failure and due to right ventricular dependent coronary circulation. Finally, 10 fetuses were born alive, and most fetuses needed intervention again after birth, and achieved biventricular circulation.

Conclusion

Echocardiography plays an important role in preoperative indication evaluation, intraoperative guidance, and postoperative observation of FCI. Standardized operation is the key to ensuring the success of FCI.

Key words: Echocardiography, Ultrasonography, interventional, Fetus, Pulmonary atresia, Congenital heart disease

Gang Luo, Silin Pan, Taotao Chen, Qian Xu, Zhixian Ji, Sibao Wang, Lingyu Sun. Application of echocardiography in fetal cardiac intervention of pulmonary atresia with intact ventricular septum[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 605-609.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2023.06.006

https://chaosheng.cma-cmc.com.cn/EN/Y2023/V20/I06/605

Figures/Tables 6

References 8

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参数	术前	术后6周	t值	P值
TV（cm）	0.84±0.05	0.94±0.05	-9.960	0.001
TV/MV	0.78±0.17	0.97±0.08	-3.576	0.006
RV/LV	0.67±0.15	0.86±0.06	-3.142	0.012
PV/AV	0.76±0.14	0.84±0.18	-1.392	0.197
TVI/CC	0.35±0.56	0.36±0.01	-2.826	0.020
TR（m/s）	3.96±0.49	3.35±0.67	2.249	0.051

参数	术前	术后6周	t值	P值
TV（cm）	0.84±0.05	0.94±0.05	-9.960	0.001
TV/MV	0.78±0.17	0.97±0.08	-3.576	0.006
RV/LV	0.67±0.15	0.86±0.06	-3.142	0.012
PV/AV	0.76±0.14	0.84±0.18	-1.392	0.197
TVI/CC	0.35±0.56	0.36±0.01	-2.826	0.020
TR（m/s）	3.96±0.49	3.35±0.67	2.249	0.051

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