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- Title
Rate and Outcomes of Pulmonary Stenosis and Functional Pulmonary Atresia in Recipient Twins with Twin-Twin Transfusion Syndrome.
- Authors
Ortiz, Javier U.; Masoller, Narcís; Gómez, Olga; Bennasar, Mar; Eixarch, Elisenda; Lobmaier, Silvia M.; Crispi, Fàtima; Gratacos, Eduard; Martinez, Josep María
- Abstract
<bold>Objective: </bold>To evaluate the rate of pulmonary stenosis and functional pulmonary atresia (PS/PA) in recipient twins prior to fetal surgery for twin-twin transfusion syndrome (TTTS) and their pre- and postnatal outcomes.<bold>Methods: </bold>We carried out a prospective study including 260 cases of TTTS. Echocardiography was performed before laser surgery to detect the presence of PS/PA. The outcomes of recipients with and without PS/PA were compared. The need of postnatal cardiac interventions and the survival rate at 6 months of age were also evaluated.<bold>Results: </bold>PS was observed in 16/260 (6.2%) of recipient twins and PA in 12/260 (4.6%). After fetal surgery, 10/28 (35.7%) recipients died, 9/28 (32.1%) showed in utero regression, and 9/28 (32.1%) had persistence of PS/PA. Postnatally, seven recipients underwent percutaneous balloon pulmonary valvuloplasty, one required surgical valvotomy and one palliative surgery. Pregnancies with recipient twins with PS/PA had lower survival of at least one twin (67.9 vs. 83.6%, p = 0.045) and lower overall survival (57.1 vs. 72.8%, p = 0.015) at 6 months of age.<bold>Conclusion: </bold>PS and PA were observed in 10.8% of recipients. Among these, about one third showed persistence of pulmonary valve pathology after delivery, which stresses the need for strict follow-up.
- Subjects
PULMONARY atresia; STENOSIS; SURGICAL complications; PERCUTANEOUS balloon valvuloplasty; PULMONARY stenosis; LONGITUDINAL method; SURVIVAL; TREATMENT effectiveness; FETOFETAL transfusion
- Publication
Fetal Diagnosis & Therapy, 2017, Vol 41, Issue 3, p191
- ISSN
1015-3837
- Publication type
journal article
- DOI
10.1159/000448075