Pulmonary stenosis in complicated monochorionic twin pregnancies: prevalence, management and outcome

Abstract

An elevated PSV-PA at the time of PS diagnosis and a short time-interval between fetoscopic laser surgery and PS diagnosis are predictive of the need for interventional treatment after birth.

Rate and Outcomes of Pulmonary Stenosis and Functional Pulmonary Atresia in Recipient Twins with Twin-Twin Transfusion Syndrome

“…These findings are consistent with data recently reported in recipient fetuses with PS [20] . However, the relatively small sample does not allow to draw definitive conclusions.…”

“…Our data are in agreement with previous studies [9,10,20] and suggest that the severity of TTTS is associated with an increased risk of right ventricular outflow tract abnormalities in recipients.…”

“…This might be partially explained by differences in severity case mix, over-ascertainment due to smaller sample sizes, and a variable definition of right ventricular outflow tract abnormalities in previous studies. More recently, Michelfelder et al [10] and Stagnati et al [20] reported lower rates of PS/PA (6.6%) and PS (2.1%), respectively, in larger cohorts. Differences with the current study might be explained by the retrospective nature of those studies and the fact that in the latter, fetal echocardiography was not systematic but performed only in cases with suspicion of PS/PA.…”

“…The diagnosis criteria for PS were increased peak systolic velocity (>120 cm/s) and turbulent flow across the pulmonary valve with or without presence of thickened and domed pulmonary valve cusps associated with structural or functional right heart abnormalities (e.g. right Color version available online ventricle hypertrophy, dysplastic pulmonary valve, TR, abnormal ductus venosus) [20] ( fig. 1 a).…”

Diverse outcome following early prenatal diagnosis of pulmonary stenosis

“…Although PS is relatively common, prenatal diagnosis of this congenital heart defect has been reported only rarely. In these cases, a distinction was made between the finding of pure PS and the more severe finding of pulmonary atresia with an intact ventricular septum.…”