Intrauterine cardiothoracic surgery: the fetal lamb model

Area of Science:

• Cardiovascular Surgery
• Fetal Surgery
• Neonatal Research

Background:

• Congenital cardiothoracic lesions pose significant challenges in early infancy.
• Developing effective surgical repair techniques requires robust preclinical models.
• Existing models may not fully replicate the complex pathophysiology and progression of these conditions.

Purpose of the Study:

• To establish a reproducible fetal lamb model for studying congenital cardiothoracic lesions.
• To facilitate the development of surgical techniques for both postnatal and intrauterine repair.
• To enable physiological studies of these conditions from fetal development through to birth.

Main Methods:

• Developed fetal lamb models of pulmonary stenosis, aortic stenosis, and diaphragmatic hernia.
• Performed simulated and actual lesion creation and repair procedures in utero.
• Utilized transplacental anesthesia and perfusion during fetal surgical interventions.
• Allowed fetuses to progress to birth for postnatal physiological study or underwent subsequent intrauterine repair.

Main Results:

• Successfully created reproducible anatomical and pathophysiological models of congenital cardiothoracic lesions.
• The model allowed for the study of simulated and actual lesions and repairs.
• Included 48 lambs with created models and 14 control lambs.
• Gestational age at intervention ranged from 90 to 120 days.

Conclusions:

• The fetal lamb model provides a viable platform for studying congenital cardiothoracic lesions.
• This model supports the development of techniques for early infancy and intrauterine surgical repair.
• Offers potential for advancing fetal surgical interventions for cardiothoracic abnormalities.