FETAL SURGICAL PROTOCOLS IN YUCATAN MINIATURE SWINE

Thirty-nine Yucatan miniature swine were used in three fetal surgical experimental protocols, They involved antiarrhythmic administration, p acemaker implantation, and in-utero diagnosis of ventricular septal de fect by intraoperative echocardiography. Because of problems encounter ed with surgical protocols in the initial stages, modifications were m ade to prevent fetal hypothermia and intraoperative mortality, These m odifications included environmental temperature support, staple surgic al techniques to reduce operative time, and development of fetal cathe ters designed to facilitate cannulation of small vessels, Postoperativ e care protocols were intensive and included antibiotics, analgesics, and supportive care designed to reduce discomfort and prevent abortion and sepsis, Thirty-seven of 39 sows survived the surgical procedures; experiments were performed on 117 fetuses. Twenty-two fetuses died ei ther intraoperatively or postoperatively because of complications rela ted to the experimental protocols, Modification of surgical and postsu rgical protocols for these projects demonstrates the feasibility of us ing miniature swine as a model for fetal surgery, when their use was a ppropriate for anatomic and physiologic reasons.