Turley K, Vlahakes G J, Harrison M R, Messina L, Hanley F, Uhlig P N, Ebert P A
Ann Thorac Surg. 1982 Oct;34(4):422-6. doi: 10.1016/s0003-4975(10)61404-x.
We have developed fetal lamb models of congenital cardiothoracic lesions that have been allowed to progress through birth for physiological study. Simulated lesions, simulated repairs, actual lesions, and actual repairs have been performed in this model. Sixty-two fetal lambs comprised the study group, including 48 in which models were created and 14 controls. Models included pulmonary stenosis, aortic stenosis, and diaphragmatic hernia. Gestational age ranged from 90 to 120 days (0.6 of normal gestation). In each pregnant ewe, laparotomy and hysterotomy were performed under general anesthesia, with care taken to avoid placental vessels. The foreleg was exposed, the appropriate anterior chest wall was isolated, and a thoracotomy was done. Thoracic or cardiac procedures then were performed under controlled transplacental anesthesia and perfusion. Following completion of the procedure, the fetal thoracotomy was closed, sterile antibiotic solution was placed in the amniotic sac, and the hysterotomy and laparotomy were closed. Subsequently the fetus either was allowed to progress to birth and infant study or underwent subsequent intrauterine repair and then was allowed to progress to birth and neonatal study. This fetal lamb model provides reproducible anatomical and pathophysiological lesions to facilitate the development of techniques for repair of such lesions in early infancy. Further, it offers the potential for developing methods of intrauterine cardiothoracic surgical repair.
我们已经建立了先天性心胸病变的胎羊模型，并使其发育至出生以进行生理学研究。在该模型中进行了模拟病变、模拟修复、实际病变和实际修复操作。62只胎羊组成了研究组，其中48只用于创建模型，14只为对照组。模型包括肺动脉狭窄、主动脉狭窄和膈疝。胎龄范围为90至120天（正常妊娠期的0.6）。对每只妊娠母羊在全身麻醉下进行剖腹术和子宫切开术，注意避开胎盘血管。暴露前肢，分离适当的前胸壁，然后进行开胸手术。随后在可控的经胎盘麻醉和灌注下进行胸部或心脏手术。手术完成后，关闭胎儿开胸伤口，将无菌抗生素溶液注入羊膜囊，然后关闭子宫切开术和剖腹术的切口。随后，让胎儿发育至出生并进行婴儿期研究，或者先进行宫内修复，然后发育至出生并进行新生儿期研究。这种胎羊模型提供了可重复的解剖和病理生理病变，以促进早期婴儿期此类病变修复技术的发展。此外，它还为开发宫内心胸外科修复方法提供了可能性。
