Bical O, Gallix P, Donzeau-Gouge P, Laborde F, de Riberolles C, Tran Viet T, Toussaint M, Sidi D, Neveux J Y
Arch Mal Coeur Vaiss. 1985 Mar;78(3):445-9.
An experimental model of pulmonary stenosis was created in ewes, fetus and repaired before birth by making use of the materno-foetal circulation. Eighteen ewes fetus underwent pulmonary artery banding at an average of 87 +/- 8 days' gestation (normal 135-145 days). All were reoperated before term at 132 +/- 6 days' gestation. They were divided into two groups : group I (7 fetus) was used to evaluate the experimental model of pulmonary stenosis by measuring right ventricular pressures (80 +/- 16 mmHg compared to 58 +/- 10 mmHg in control models), and the increase in right ventricular mass (2.8 +/- 0.5 X 10(-3) g vs 1.9 +/- 0.2 X 10(-3) g), left ventricular mass (2.2 +/- 0.3 X 10(-3) g vs 1.8 +/- 0.4 X 10(-3) g) and septal mass (1.8 +/- 0.3 X 10(-3) g vs 1.3 +/- 0.2 X 10(-3) g). In group II (11 fetus) the pulmonary stenosis was repaired by total clamping and patch repair. After repair and during the days just before birth, the ventricular masses decreased (RV = 2 +/- 0.3 X 10(-3) g; LV = 1.8 +/- 0.4 X 10(-3) g; septum = 1.8 +/- 0.3 X 10(-3) g) approaching values of normal control fetus. This experimental model shows that it is possible to correct cardiac lesions in utero by making use of the materno-fetal circulation and that antenatal repair of an arterial obstruction can rapidly reverse the reactional ventricular hypertrophy.
通过利用母胎循环，在母羊胎儿中建立了肺动脉狭窄的实验模型，并在出生前进行修复。18只母羊胎儿在平均妊娠87±8天（正常为135 - 145天）时接受肺动脉环扎术。所有胎儿均在妊娠132±6天足月前再次手术。它们被分为两组：第一组（7只胎儿）用于通过测量右心室压力（与对照模型中的58±10 mmHg相比为80±16 mmHg）以及右心室质量增加（2.8±0.5×10⁻³ g对1.9±0.2×10⁻³ g）、左心室质量（2.2±0.3×10⁻³ g对1.8±0.4×10⁻³ g）和室间隔质量（1.8±0.3×10⁻³ g对1.3±0.2×10⁻³ g）来评估肺动脉狭窄的实验模型。在第二组（11只胎儿）中，通过完全钳夹和补片修复来修复肺动脉狭窄。修复后以及出生前几天，心室质量下降（右心室 = 2±0.3×10⁻³ g；左心室 = 1.8±0.4×10⁻³ g；室间隔 = 1.8±0.3×10⁻³ g），接近正常对照胎儿的值。该实验模型表明，利用母胎循环在子宫内纠正心脏病变是可能的，并且动脉阻塞的产前修复可以迅速逆转反应性心室肥大。
