Physiology of the fetal and neonatal circulations and fetal cardiac surgery

This chapter covers the physiology of the fetal and neonatal circulations and fetal cardiac surgery. The major flow patterns, cardiac output, oxygenation, and distribution are covered in detail, including intracardiac and vascular pressures. At birth, the pattern of circulation changes from the fetal “parallel” type to the adult “series” type; these changes are discussed. The second part of the chapter covers fetal cardiac surgery. Animal models are discussed with reference to hemodynamics and the fetal stress response. Finally, the role of the endothelium in placental dysfunction, the fetal bypass circuit, and fetal myocardial protection are covered.