2010
DOI: 10.1002/uog.7748
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Effect of selective fetoscopic laser photocoagulation therapy for twin–twin transfusion syndrome on pulmonary valve pathology in recipient twins

Abstract: Objective To investigate the impact of selective fetoscopic laser photocoagulation (SFLP) on pre-existing pulmonary valve pathology in the recipient twin in twin-twin transfusion syndrome (TTTS). Methods

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Cited by 44 publications
(67 citation statements)
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“…84,133 The incidence of pulmonary stenosis may be lower if the pregnancy is successfully treated with invasive laser photocoagulation of the intertwin anastomosis. 84,133,134 Fetal echocardiogram is recommended in all monochorionic twin gestations.…”
Section: Monochorionic Twinningmentioning
confidence: 99%
See 1 more Smart Citation
“…84,133 The incidence of pulmonary stenosis may be lower if the pregnancy is successfully treated with invasive laser photocoagulation of the intertwin anastomosis. 84,133,134 Fetal echocardiogram is recommended in all monochorionic twin gestations.…”
Section: Monochorionic Twinningmentioning
confidence: 99%
“…Right ventricular outflow tract abnormalities such as pulmonary stenosis, pulmonary atresia, and pulmonary insufficiency have also been reported. 162,[503][504][505] Despite successful fetoscopic laser therapy, a significant proportion of right ventricular outflow tract abnormalities documented in utero persist after birth. 84 Changes in venous Doppler flow patterns in the hepatic veins, ductus venosus, and umbilical vein consistent with elevated fetal central venous pressure can manifest, particularly in the recipient twin of TTTS.…”
Section: Cardiac Effectsmentioning
confidence: 99%
“…136 If recipient cardiomyopathy exists the time needed for cardiac function back to normal levels after laser treatment is in average 4 weeks. 137 Abnormalities of the pulmonary valve, which are seen mainly in the recipient twins, have also been noted to improve after laser decreasing the number of fetuses needing surgery after delivery. 137 Eighty seven percent recipient twins who survived after laser treatment for severe TTTS, were reported to have normal cardiac function at about 2 years after delivery.…”
Section: Complications Of Laser Treatmentmentioning
confidence: 99%
“…137 Abnormalities of the pulmonary valve, which are seen mainly in the recipient twins, have also been noted to improve after laser decreasing the number of fetuses needing surgery after delivery. 137 Eighty seven percent recipient twins who survived after laser treatment for severe TTTS, were reported to have normal cardiac function at about 2 years after delivery. 138 Other complications that have been documented with laser treatment involve amniotic fluid leakage into the maternal peritoneal cavity, vaginal bleeding, placental abruption and chorioamnionitis.…”
Section: Complications Of Laser Treatmentmentioning
confidence: 99%
“…Furthermore, delivery of the twins at a viable age is also associated with the resolution of the cardiovascular pathology of the recipient over days to weeks. Interestingly when left untreated 10-11% of the recipient twins evolve pulmonary outflow obstruction [91] decreasing to an incidence of 2% among treated pregnancies [116], and this is believed to occur at least in part due to greater involvement of the right ventricle. The exact etiology of the recipient cardiovascular pathology is not as yet known, however, it has been speculated that increased levels of circulating vasoactive peptides and mitogens expressed by the placenta in response to the donor arterial blood could contribute [117,118] In contrast to the recipient, left heart obstruction in the form of coarctation of the aorta has been reported among the smaller donor twins [119].…”
Section: High Output Statesmentioning
confidence: 99%