Fetal surgical management of congenital heart block in a hydropic fetus: Lessons learned from a clinical experience Pirooz Eghtesady, MD, PhD, Erik C.

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Presentation transcript:

Fetal surgical management of congenital heart block in a hydropic fetus: Lessons learned from a clinical experience Pirooz Eghtesady, MD, PhD, Erik C. Michelfelder, MD, Timothy K. Knilans, MD, David P. Witte, MD, Peter B. Manning, MD, Timothy M. Crombleholme, MD, FACS, FAAP The Journal of Thoracic and Cardiovascular Surgery Volume 141, Issue 3, Pages 835-837 (March 2011) DOI: 10.1016/j.jtcvs.2010.06.048 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A, Fetal heart rate with development of hydrops in a fetus of a mother with systemic lupus erythematosus and anti-Ro and anti-La antibodies. B, Temporal records of combined cardiac output and fetal heart rate generated from weekly echocardiograms over preoperative and postoperative days after pacemaker insertion. Fetal demise occurred on postoperative day 5. CV, Cardiovascular; EGA, estimated gestational age; BID, 2 times per day; QID, 4 times per day; HR, heart rate; POD, postoperative day. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 835-837DOI: (10.1016/j.jtcvs.2010.06.048) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Sections from the right ventricle show prominent endocardial sclerosis and uniformly thickened layers of fibroelastic stroma (hematoxylin–eosin magnification 10×). B, The left ventricular myocardium shows necrosis with loss of cytoplasmic detail and increased eosinophilia (hematoxylin–eosin magnification 40×). C, The epicardial surface (right half of picture) shows extensive dystrophic calcification and fibrosis (hematoxylin–eosin magnification 10×). D, The liver shows evidence of severe chronic passive congestion of the lobule. There is extensive atrophy of the hepatic chords, sinusoidal fibrosis, and prominent extramedullary hematopoiesis in the sinusoids. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 835-837DOI: (10.1016/j.jtcvs.2010.06.048) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions