Fechner S, Busch C, Oppitz M, Drews U, Meyer-Wittkopf M
Department of Obstetrics and Gynecology, Institute of Anatomy, University of Tübingen, Tübingen, Germany.
Ultrasound Obstet Gynecol. 2008 Mar;31(3):277-83. doi: 10.1002/uog.5244.
Prenatal minimally invasive therapy represents a challenging option for reducing long-term complications of pathological fetal heart development. Here, the potential of the chick embryo as a model for ultrasound-guided intrauterine cardiac intervention is explored.
Chick embryos were incubated for 18 days in fenestrated eggs and their hearts were punctured in ovo under ultrasound guidance. Indian ink and Nile blue sulfate were applied to mark the injection channel. After cardiac intervention, embryos were further incubated and subsequently sacrificed for macroscopic and histological evaluation of the heart.
Stereomicroscopic analysis revealed that the catheter had successfully penetrated the cardiac ventricular wall in 26/38 embryos. The myocardium was not severely injured. Histological evaluation showed that the myocardium had almost reoccluded after the intervention and that the injection channel was clogged with fibrin. In one case, the embryo was not sacrificed, but was removed from the egg 24 h after the intervention, with no signs of cardiac dysfunction, and was followed up for 6 months.
Intrauterine ultrasound-guided heart intervention in the human fetus can be simulated in the chick embryo. Fenestrated eggs have to be used because the egg shell and shell membrane are impermeable to ultrasound.
产前微创治疗是减少病理性胎儿心脏发育长期并发症的一种具有挑战性的选择。在此，探讨鸡胚作为超声引导下宫内心脏干预模型的潜力。
将鸡胚在有小孔的鸡蛋中孵育18天，在超声引导下对其心脏进行卵内穿刺。应用印度墨水和硫酸尼罗蓝标记注射通道。心脏干预后，将胚胎进一步孵育，随后处死以对心脏进行宏观和组织学评估。
体视显微镜分析显示，导管在38个胚胎中的26个中成功穿透心室壁。心肌未受到严重损伤。组织学评估显示，干预后心肌几乎重新闭塞，注射通道被纤维蛋白堵塞。在1例中，胚胎未处死，而是在干预后24小时从鸡蛋中取出，无心脏功能障碍迹象，并随访6个月。
在鸡胚中可模拟人类胎儿宫内超声引导下的心脏干预。必须使用有小孔的鸡蛋，因为蛋壳和壳膜对超声不渗透。
