Impaired Endothelial Function of the Umbilical Artery After Fetal Cardiac Bypass

Oishi, Yoshifumi; Masuda, Mitsuharu; Yasutsune, Toru; Boku, Noriko; Tokunaga, Shigehiko; Morita, Shigeki; Yasui, Hirofumi

doi:10.1016/j.athoracsur.2004.05.057

Cited by 9 publications

(9 citation statements)

References 17 publications

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“…These might be related to the pathophysiological changes of fetal cardiac bypass. Previous studies demonstrated that fetal cardiac bypass increased placental vascular resistance through a variety of vasoconstrictor and cytokines (8,9). We also showed evidence of increase in placental vascular resistance after cardiac bypass, which increased the afterload of fetal right ventricle and reduced placental gas exchange function.…”

Section: Discussionsupporting

confidence: 72%

“…Establishment of a safe fetal cardiac bypass is thus a prerequisite for fetal cardiac surgery. However, early studies demonstrated that fetal cardiac bypass could be detrimental to placental function (5–9), and placental insufficiency could compromise fetal cardiac function (10). We hypothesized that fetal cardiac bypass influenced the secretion of ANP and fetal cardiac function following the bypass.…”

mentioning

confidence: 98%

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Changes in Atrial Natriuretic Peptide Levels During Cardiac Bypass in the Fetal Goat

et al. 2008

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The aim of this study is to evaluate the effect of fetal cardiac bypass on the production and secretion of fetal atrial natriuretic peptide (ANP) in the goat. Eighteen pregnant goats, at days 120 to 140 of gestation, were randomly divided into control (n = 8) and bypass (n = 10) groups. The control group underwent a sham procedure involving fetal sternotomy and cannulation. The bypass group underwent fetal cardiac bypass using a centrifugal pump for 30 min. Fetuses in the bypass group exhibited hypoxia, hypercapnia, and acidosis during and after cardiac bypass. The pulse index (PI) of the umbilical artery in the bypass group increased significantly after cardiac bypass compared with the control group. Tei indices of the left and right ventricles in the bypass group increased remarkably after cardiac bypass. Plasma troponin I levels in the bypass group increased significantly compared with that of the control group. Plasma ANP levels increased markedly in the bypass group after cardiac bypass, and the difference between two groups was significant. Transcriptional levels of ANP mRNA in the fetal heart elevated remarkably in the bypass group compared with the control group at 2 h after the bypass. A significant positive correlation between plasma ANP levels and Tei indices of the ventricles, plasma troponin I was observed (left ventricular Tei index, r = 0.606, P < 0.01; right ventricular Tei index, r = 0.581, P < 0.01; plasma troponin I, r = 0.275, P < 0.05). In conclusion, fetal cardiac bypass promoted the production and secretion of ANP and was associated with fetal cardiac dysfunction.

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Section: Discussionsupporting

confidence: 72%

mentioning

confidence: 98%

Changes in Atrial Natriuretic Peptide Levels During Cardiac Bypass in the Fetal Goat

et al. 2008

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Section: Discussionmentioning

confidence: 99%

“…In previous CPB ovine fetal models, the placenta served as the sole oxygenator, resulting in unstable oxygenation and severe placental damage occurring (24,25). It was observed that inhibiting stress and protecting vascular endothelial function of the placenta following CPB prevented an increase in the vascular resistance of the placenta that would otherwise lead to impairment of placental function, irreversible acidosis and subsequent fetal death (24). During CPB, the following typically influence the extent of placental damage: i) Re-distribution of fetal blood flow, ii) placental vascular endothelial dysfunction, iii) humoral factors, iv) perfusion patterns, v) pre-perfusion solution, and vi) low temperatures (25).…”

Section: Discussionmentioning

confidence: 99%

Assessing the impact of total extracorporeal circulation on hemodynamics in an ovine fetal model

Xiao

Zhuang

Zhou

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The present study aimed to evaluate the impact of total extracorporeal circulation on hemodynamics and placental function in an ovine fetal model. Mid-term ovine fetuses (n=6) underwent extracorporeal circulation (30 min), cardioplegic arrest (20 min) and monitoring (120 min). The ascending aorta and umbilical cords of the fetuses were occluded during the bypass and an extracorporeal membrane oxygenator was used as the oxygen source. Biventricular intracardiac pressures, echocardiographic data, blood gas levels and placental function variables were recorded, and statistical analysis was performed using the repeated-measure analysis of variance test. The data indicated that fetal heart rate and blood pressure at 30, 60, 90 and 120 min following the bypass were stable relative to pre-arrest baseline (pre-bypass) values (P>0.05). However, end diastolic pressures in the ovine right ventricles post-bypass were significantly increased at 30, 60, 90 and 120 min relative to pre-bypass pressures (P<0.05). The pulsatility index also increased at 30 min post-bypass relative to the pre-bypass score (0.91±0.06 vs. 0.61±0.14; P=0.007). The mean resistivity index at all time points post-bypass was consistent with the pre-bypass score (P>0.05), while the mean Tei index values for the left and right ventricles post-bypass were significantly higher at all time points relative to pre-bypass values (P<0.05). The pre-bypass fetal blood pH, SaO 2 , base excess and lactate values were maintained during arrest (P>0.05). Fetal hemodynamics and placental function additionally remained stable for up to 2 h upon reperfusion following total extracorporeal circulation and cardioplegic arrest. Collectively these data suggest that the reproducible ovine fetal model may be useful in the evaluation of fetal cardiac surgery.

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“…They release NO to regulate the tension of umbilical vessels, and mitigate the constrictive effect of embroxane and endothelin. [9] Oishi et al [10] found that increased umbilical artery resistance is due to deterioration of the endothelium dependent vasodilator effect. The endothelium independent vasodilator (nitroprusside) function is not altered.…”

Section: Shanghai Chinamentioning

confidence: 99%

Fetal cardiac surgery—a big challenge in the 21st century

Chen

2008

World J Pediatr

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Impaired Endothelial Function of the Umbilical Artery After Fetal Cardiac Bypass

Cited by 9 publications

References 17 publications

Changes in Atrial Natriuretic Peptide Levels During Cardiac Bypass in the Fetal Goat

Changes in Atrial Natriuretic Peptide Levels During Cardiac Bypass in the Fetal Goat

Assessing the impact of total extracorporeal circulation on hemodynamics in an ovine fetal model

Fetal cardiac surgery—a big challenge in the 21st century

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