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胎儿心脏介入治疗——波兰从“零”到世界第三大项目的经验

Fetal Cardiac Interventions-Polish Experience from "Zero" to the Third World Largest Program.

作者信息

Debska Marzena, Kolesnik Adam, Rebizant Beata, Sekowska Agnieszka, Grzyb Agnieszka, Chaberek Katarzyna, Witwicki Jacek, Debski Romuald, Dangel Joanna

机构信息

2nd Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland.

Department of Gynecologic Oncology and Obstetrics, Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.

出版信息

J Clin Med. 2020 Sep 7;9(9):2888. doi: 10.3390/jcm9092888.

Abstract

This article presents the technical aspects of the Polish fetal cardiac interventions (FCI) program, including preparation of the team and modifications in the technique of the procedure that aim to increase its safety for the mother and the fetus. Over 9 years, 128 FCI in 113 fetuses have been performed: 94 balloon aortic valvuloplasties (fBAV), 14 balloon atrioseptoplasties (fBAS) with stent (BAS+), 5 balloon atrioseptoplasties without stent placement (BAS-), and 15 fetal pulmonary valvuloplasties (fBPS). The technical success rate ranged from 80% (BAS-) to 89% (fBAV), while the procedure-related death rate (defined as death within 72 hours following the procedure) ranged from 7% (fBAV and fBPV) to 20% (BAS). There were 98 live births after all FCI (3 pregnancies continue). Median gestational age at delivery was 39 weeks in our center and 38 weeks in other centers.

摘要

本文介绍了波兰胎儿心脏介入治疗(FCI)项目的技术层面内容,包括团队准备以及手术技术的改进,旨在提高对母亲和胎儿的安全性。在9年多的时间里,对113例胎儿进行了128次FCI手术:94例球囊主动脉瓣成形术(fBAV)、14例带支架的球囊房间隔成形术(fBAS+)、5例未放置支架的球囊房间隔成形术(BAS-)以及15例胎儿肺动脉瓣成形术(fBPS)。技术成功率从80%(BAS-)到89%(fBAV)不等,而手术相关死亡率(定义为手术后72小时内死亡)从7%(fBAV和fBPV)到20%(BAS)不等。所有FCI手术后有98例活产(3例妊娠仍在继续)。在我们中心,分娩时的中位孕周为39周,在其他中心为38周。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1475/7576494/97aed077c990/jcm-09-02888-g001.jpg

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