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既往观点认为,一旦胎儿患有左心发育不良综合征(HLHS)等严重心血管畸形,结局就只能是出生后功能性单心室循环、心脏移植或中止妊娠。到目前为止,开放性胎儿心脏外科技术尚不成熟,而通过胎儿心脏介入治疗技术可以在很大程度上阻止因先天性心脏病引起的胎儿水肿、自发性流产或胎儿死亡,促进发育不良的心室重新发育,形成生后的双心室循环,重塑右室流出道梗阻胎儿的肺血管床等,改善了胎儿严重心血管畸形的预后。这些进步在很大程度上依赖于对胎儿先天性心脏病病理生理学特点的准确判断。超声技术的发展以及其他评价手段的进步可促进目前还比较有限的胎儿先天性心脏病介入治疗进一步发展。
The past view that, once the fetus with left heart dysplasia (HLHS) and other serious cardiovascular malformations, the outcome can only be functional single ventricle after birth, cardiac transplantation or termination of pregnancy. So far, open fetal cardiac surgery is not yet mature, and fetal cardiac intervention can largely prevent fetal edema, spontaneous abortion or fetal death caused by congenital heart disease, and promote dysplastic ventricular Redevelopment, the formation of bi-ventricular circulation after birth, remodeling the right ventricular outflow obstruction of fetal pulmonary vascular bed, etc., to improve the prognosis of fetal severe cardiovascular malformations. These advances depend heavily on accurate judgment of the pathophysiology of fetal congenital heart disease. The development of ultrasound technology and other evaluation methods can promote the further development of interventional treatment of fetal congenital heart disease, which is still relatively limited.