背景:先天性心脏病(CHDs)是最常见的先天性病理,它们是胎儿发育过程中结构和功能异常的结果。CHD的病因涉及遗传和环境因素的相互作用。胎儿心脏手术旨在防止子宫内CHD的自然途径,缓解进展为更复杂的异常。这篇综述的目的是证明胎儿干预在两种最普遍的CHD中的益处和风险。室间隔完整的肺动脉狭窄和肺动脉闭锁,还有严重的主动脉瓣狭窄和左心发育不全综合征.
方法:通过meta汇总选择原始和相关文章,对肺动脉狭窄和临界主动脉瓣狭窄的胎儿心脏介入治疗进行定性分析。JoannaBriggs研究所的定性评估和审查工具(或JBI-QARI)用于数据质量评估。
结果:在61篇潜在文章中,13人被选中,最终包括了9个。讨论:本综述表明,胎儿心脏手术可增加肺动脉瓣狭窄的右心室生长和血流动力学流量,而在严重的主动脉瓣狭窄中,它使左心室生长并增加左心室压力。然而,它的并发症发生率很高,伴随着相当大的发病率和死亡率。
结论:胎儿心脏手术对肺动脉狭窄和严重主动脉瓣狭窄的益处在文献中有很好的描述;然而,外科医生的技术专长和结构良好的医院设施可以减少并发症的风险。
Congenital heart diseases (CHDs) constitute the most prevalent congenital pathology, and they are a consequence of structural and functional abnormalities during fetal development. The etiology of CHD involves the interaction of genetic and environmental factors. Fetal cardiac surgery aims at preventing natural pathways of CHD in utero, mitigating progression to more complex abnormalities. The goal of this
review was to demonstrate the benefits and risks of fetal interventions in the two most prevalent CHDs, pulmonary stenosis and pulmonary atresia with an intact ventricular septum, but also critical aortic stenosis and hypoplastic left heart syndrome.
Original and relevant articles were selected by meta-aggregation to perform a qualitative analysis of fetal cardiac interventions for pulmonary stenosis and critical aortic stenosis. The Joanna Briggs Institute\'s Qualitative Assessment and
Review Instrument (or JBI-QARI) was used for data quality appraisal.
Of 61 potential articles, 13 were selected, and nine were finally included. Discussion: The present
review demonstrated that fetal cardiac surgery increases right ventricular growth and hemodynamic flow in pulmonary stenosis, whereas in critical aortic stenosis it enables growth of the left ventricle and increases left ventricular pressure. However, it has a high complication rate, along with considerable morbidity and mortality.
The benefits of fetal cardiac surgery for pulmonary stenosis and critical aortic stenosis are well-described in the literature; however, there is a significant risk of complications which can be reduced by the surgeon\'s technical expertise and well-structured hospital facilities.