Impact of selective laser ablation of placental anastomoses on the cardiovascular pathology of the recipient twin in severe twin-twin transfusion syndrome.
Am J Obstet Gynecol
; 195(5): 1388-95, 2006 Nov.
Article
en En
| MEDLINE
| ID: mdl-16777050
ABSTRACT
OBJECTIVES:
We investigated the impact of selective laser ablation on the cardiovascular pathology of the recipient twin in twin-twin transfusion syndrome. STUDYDESIGN:
Fetal echocardiograms and medical records were reviewed from 22 pregnancies with severe twin-twin transfusion syndrome where echocardiography was performed before and after laser.RESULTS:
Before laser, cardiomegaly associated with right and/or left ventricular hypertrophy without ventricular dilatation, was observed in most cases. Right ventricular and left ventricular systolic dysfunction (shortening fraction <28%) was present in 59% and 27%, respectively, and diastolic dysfunction (based on inflow and venous Dopplers) in 73%. Shortly after laser, biventricular systolic function improved significantly and diastolic function tended to improve (50%, P = .06). Functional pulmonary atresia, secondary to right ventricular systolic dysfunction, resolved in 2 of 2 cases at post-laser echocardiography. On serial assessment, diastolic function was normal in 7 of 10, hydrops regressed in 4 of 5, and neither progressive myocardial hypertrophy nor anatomical right ventricular outflow obstruction were found.CONCLUSIONS:
Selective laser ablation in severe twin-twin transfusion syndrome acutely improves biventricular systolic function and tends to improve diastolic function in the recipient twin.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Placenta
/
Anastomosis Arteriovenosa
/
Gemelos
/
Cardiomegalia
/
Terapia por Láser
/
Transfusión Feto-Fetal
/
Cardiopatías
Límite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Am J Obstet Gynecol
Año:
2006
Tipo del documento:
Article
País de afiliación:
Canadá