干预后胎儿大动脉反:在大型单中心队列中对胎儿循环的流行率,结果和影响
A Tulzer1,2, J Hochpoechler1,2, I Scharnreitner2,3
1Children's Heart Center Linz, Department of Pediatric Cardiology, Kepler University Hospital, Linz, Austria.
概括
胎儿大动脉吐 (AR) 在胎儿大动脉膜整形术 (FAV) 后很常见,但其严重程度往往会降低. 显著的AR与更高的气球与大动脉门比率有关,并影响胎儿的血液循环.
科学领域:
- 心脏病学 心脏病学
- 胎儿医学 胎儿医学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 胎儿的临界大动脉狭窄症带来了重大挑战.
- 胎儿大动脉膜整形 (FAV) 是一种治疗干预.
- 了解FAV后的后果对于胎儿健康管理至关重要.
研究的目的:
- 为了确定成功FAV后胎儿大动脉反 (AR) 的患病率和严重程度.
- 评估AR对胎儿循环和左心室 (LV) 增长的影响.
- 为了确定FAV之后AR的风险因素.
主要方法:
- 回顾成功接受FAV (2010-2024) 的胎儿的回顾性审查.
- 对膜和心室维度进行胎儿和产后心声图的分析.
- 计算MCA-PI,UA-PI和大脑胎盘比率的Z分数.
- 对AR严重程度的分类和气球对大动脉门比率 (BVR) 的计算.
主要成果:
- 87%的胎儿在FAV后发展了AR,其中45%具有显著的AR.
- 较高的BVR与显著的AR相关 (P < 0.001).
- 甲状腺炎的患病率显著下降,从产前86%降至产后58%.
- 显著的AR胎儿显示出更大的LV长度增加和改变的血液动力学参数 (MCA-PI,UA-PI Z-scores).
结论:
- FAV与胎儿AR的高发病率有关,胎儿AR的严重程度往往会下降.
- 重要的胎儿AR与更高的BVR密切相关,并影响胎儿血液动力学.
- FAV结果需要对AR及其血液动力学后果进行仔细监测.
相关概念视频
Fetal Circulation
Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Aortic Regurgitation I: Introduction
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Aortic Regurgitation IV: Nursing Management
A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...


