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- Title
Thoracoamniotic Shunts in Macrocystic Lung Lesions: Case Series and Review of the Literature.
- Authors
Litwińska, Magdalena; Litwińska, Ewelina; Janiak, Katarzyna; Piaseczna-Piotrowska, anna; Gulczyńska, Ewa; Szaflik, Krzysztof
- Abstract
<bold>Objective: </bold>To evaluate the efficiency of thoracoamniotic shunts for drainage of macrocystic-type congenital cystic adenomatoid malformation (CCAM).<bold>Subjects and Methods: </bold>This was a retrospective study of 12 fetuses with a large thoracic cyst treated with thoracoamniotic shunting between 2004 and 2014 in a tertiary fetal therapy center. Medline was searched to identify cases of CCAM treated with thoracoamniotic shunting.<bold>Results: </bold>In all cases the thoracic cyst was associated with major mediastinal shift, the CCAM volume ratio (CVR) was >1.6, and in eight cases there was associated hydrops. Shunt insertion was successfully carried out in all cases at a median gestational age of 24 weeks (range 18-34). In 10 cases there was live birth at a median age of 38 weeks (range 35-41), but in two hydropic fetuses there was intrauterine death. A literature search identified a total of 98 fetuses with CCAM treated with thoracoamniotic shunting between 1987 and 2016. In the combined data from the previous and the current study, the survival rate was 77% (53 of 69) for hydropic and 90% (37 of 41) for nonhydropic fetuses.<bold>Conclusions: </bold>The role of thoracoamniotic shunting in macrocystic lung lesions associated with hydrops is well accepted. Intrauterine intervention is also likely to be beneficial in the subgroup of nonhydropic fetuses with a CVR >1.6.
- Subjects
ADENOMATOID tumors; FETAL abnormalities; HYDROPS fetalis; SURGICAL anastomosis; THORACIC vertebrae; CATHETERIZATION; FETAL ultrasonic imaging; LUNG abnormalities; RETROSPECTIVE studies; THORACOTOMY; EQUIPMENT &; supplies
- Publication
Fetal Diagnosis & Therapy, 2017, Vol 41, Issue 3, p179
- ISSN
1015-3837
- Publication type
journal article
- DOI
10.1159/000448095