{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:05:02Z","timestamp":1790316302047,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"6-7","license":[{"start":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T00:00:00Z","timestamp":1716940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000023","name":"Government of Canada","doi-asserted-by":"publisher","award":["NFRFE\u20102021\u201000860"],"award-info":[{"award-number":["NFRFE\u20102021\u201000860"]}],"id":[{"id":"10.13039\/501100000023","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001655","name":"Deutscher Akademischer Austauschdienst","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001655","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["RN403952 \u2010 426942"],"award-info":[{"award-number":["RN403952 \u2010 426942"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We evaluated fetal cardiovascular physiology and mode of cardiac failure in premature miniature piglets on a pumped artificial placenta (AP) circuit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fetal pigs were cannulated via the umbilical vessels and transitioned to an AP circuit composed of a centrifugal pump and neonatal oxygenator and maintained in a fluid\u2010filled biobag. Echocardiographic studies were conducted to measure ventricular function, umbilical blood flow, and fluid status. In utero scans were used as control data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>AP fetuses (<jats:italic>n<\/jats:italic>\u00a0=\u00a013; 102\u00b14d gestational age [term 115d]; 616\u00a0\u00b1\u00a0139\u00a0g [g]; survival 46.4\u00a0\u00b1\u00a046.8\u00a0h) were tachycardic and hypertensive with initially supraphysiologic circuit flows. Increased myocardial wall thickness was observed. Signs of fetal hydrops were present in all piglets. Global longitudinal strain (GLS) measurements increased in the left ventricle (LV) after transition to the circuit. Right ventricle (RV) and LV strain rate decreased early during AP support compared with in utero measurements but recovered toward the end of the experiment. Fetuses supported for &gt;24\u00a0h had similar RV GLS to in utero controls and significantly higher GLS compared to piglets surviving only up to 24\u00a0h.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Fetuses on a pump\u2010supported AP circuit experienced an increase in afterload, and redistribution of blood flow between the AP and systemic circulations, associated with elevated end\u2010diastolic filling pressures. This resulted in heart failure and hydrops. These preterm fetuses were unable to tolerate the hemodynamic changes associated with connection to the current AP circuit. To better mimic the physiology of the native placenta and preserve normal fetal cardiovascular physiology, further optimization of the circuit will be required.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6612","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T14:19:36Z","timestamp":1716992376000},"page":"888-898","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Echocardiographic assessment of cardiovascular physiology of preterm miniature piglets supported with a pumped artificial placenta system"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0270-1500","authenticated-orcid":false,"given":"Henriette","family":"K\u00fchle","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Surgery The Labatt Family Heart Centre The Hospital for Sick Children University of Toronto  Toronto Ontario Canada"},{"name":"Division of Cardiology The Labatt Family Heart Centre The Hospital for Sick Children University of Toronto  Toronto Ontario Canada"},{"name":"Department of Cardiac and Thoracic Surgery University Hospital Magdeburg Otto von Guericke University Magdeburg  Magdeburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven K. S.","family":"Cho","sequence":"additional","affiliation":[{"name":"Translational Medicine Program Research Institute The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Physiology Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex J.","family":"Charest\u2010Pekeski","sequence":"additional","affiliation":[{"name":"Translational Medicine Program Research Institute The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Physiology Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica S. M.","family":"Chow","sequence":"additional","affiliation":[{"name":"Department of Physiology Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Institute of Medical Science Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6327-2834","authenticated-orcid":false,"given":"Fu\u2010Tsuen","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Labatt Family Heart Centre The Hospital for Sick Children University of Toronto  Toronto Ontario Canada"},{"name":"Translational Medicine Program Research Institute The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Physiology Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanroop","family":"Aujla","sequence":"additional","affiliation":[{"name":"Translational Medicine Program Research Institute The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Physiology Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brahmdeep S.","family":"Saini","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Labatt Family Heart Centre The Hospital for Sick Children University of Toronto  Toronto Ontario Canada"},{"name":"Translational Medicine Program Research Institute The Hospital for Sick Children  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie Mei","family":"Lim","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Labatt Family Heart Centre The Hospital for Sick Children University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack R. T.","family":"Darby","sequence":"additional","affiliation":[{"name":"Early Origins of Adult Health Research Group, Health and Biomedical Innovation Clinical and Health Sciences University of South Australia  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dariusz","family":"Mroczek","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Labatt Family Heart Centre The Hospital for Sick Children University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro A.","family":"Floh","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine The Hospital for Sick Children  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"McVey","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine The Hospital for Sick Children University of Toronto  Toronto 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