title: Myocardial effects of fetal endoscopic tracheal occlusion in lambs with CDH.
abstract: BACKGROUND
  Fetal endoscopic tracheal occlusion in congenital diaphragmatic hernia (CDH) may reduce pulmonary hypertension and ameliorate postnatal cardiac output. The effects of sustained early (ETO) and late (LTO) tracheal occlusion on left ventricular (LV) cells in the lamb model have not been described.
  
  
  METHODS
  CDH was created in lambs at 70 days' gestation (term = 145 days). ETO (85 days) or LTO (105 days) was sustained till term. After cesarean section (140 days) fetuses were euthanized and hearts harvested. LV myocardial cells were studied by histological and immunofluorescence (TGF-beta 1, endothelin-1) assays in CDH, ETO, LTO, and the control group (two subjects per group). Small intramyocardial arteries were evaluated by traditional histology.
  
  
  RESULTS
  LV myocardial histology in CDH and LTO was similar. ETO-induced LV myocardial cell enlargement and increased endothelin-1 and TGF-beta 1 staining; a weaker immunofluorescence signal was observed in LTO compared with ETO. Myocardial vascular wall thickness was greater in CDH than in controls. ETO was associated with a vascular wall thickness within the range of controls.
  
  
  CONCLUSIONS
  With only two fetuses in each group, only an explorative evaluation was possible. The time point at which TO is performed seems to have an effect on cardiac morphology. Functional studies as well as confirmation in clinical samples are mandatory.
authors: Pediatric Surgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
authors: Elisa
authors: E
authors: Zambaiti
authors: Institute of Pathologic Anatomy, University of Trieste, Trieste, Italy.
authors: Rossana
authors: R
authors: Bussani
authors: Pediatric Unit, Department of Internal Medicine, University of Pavia, Pavia, Italy.|Department of Maternal and Children's Health, Pediatric Unit, Fondazione IRCCS Policlinico San Matteo Pavia, Pavia, Italy.
authors: Valeria
authors: V
authors: Calcaterra
authors: Institute of Pathologic Anatomy, University of Trieste, Trieste, Italy.
authors: Lorenzo
authors: L
authors: Zandonà
authors: Institute of Pathologic Anatomy, University of Trieste, Trieste, Italy.
authors: Furio
authors: F
authors: Silvestri
authors: Cinicinnati Fetal Center, The Center for Fetal, Cellular, and Molecular Therapy, Pediatric Surgery Division, CCHMC, Cincinnati, OH, USA.|Fetal Surgery Program, Congenital Malformations Research Group, Research Institute of Hospital Universitari Vall d'Hebron, Edifici Infantil, Barcelona, Spain.
authors: José Luis
authors: JL
authors: Peiró
authors: Cinicinnati Fetal Center, The Center for Fetal, Cellular, and Molecular Therapy, Pediatric Surgery Division, CCHMC, Cincinnati, OH, USA.|Fetal Surgery Program, Congenital Malformations Research Group, Research Institute of Hospital Universitari Vall d'Hebron, Edifici Infantil, Barcelona, Spain.
authors: Mario
authors: M
authors: Marotta
authors: Pediatric Surgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
authors: Erika
authors: E
authors: Andreatta
authors: Pediatric Surgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
authors: Gloria
authors: G
authors: Pelizzo
mesh_terms: D000818:Animals; D005332:Fetoscopy; D006352:Heart Ventricles / Q000473:pathology*; D065630:Hernias, Diaphragmatic, Congenital / Q000503:physiopathology / Q000601:surgery*; D009206:Myocardium / Q000473:pathology*; D010865:Pilot Projects; D012756:Sheep; D014132:Trachea / Q000601:surgery*