Tracheal diameter at birth in severe congenital diaphragmatic hernia treated by fetal endoscopic tracheal occlusion

Jani, Jacques; Valencia, Catalina; Cannie, Mieke; Vuckovic, Aline; Sellars, Maria E.; Nicolaides, Kypros H.

doi:10.1002/pd.2806

Cited by 33 publications

(20 citation statements)

References 24 publications

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“…In humans this effect has been linked to the coexistence of the hypoplastic bronchial tree [38] and the effect of the occlusion itself [36,39]. In our experiments, the duration of the occlusion (3-4 weeks or 15.4% of the duration of gestation) was comparable to what was reported in humans (6-22.5% of the duration of gestation) [20]. The tracheal diameter in the baboon fetuses was within the lower range documented for the preterm human fetuses [20] and the dimensions of the balloon used in our experiments were the same as published for human fetuses (7 mm in width and 20 mm in length).…”

Section: Discussionsupporting

confidence: 76%

“…In our experiments, the duration of the occlusion (3-4 weeks or 15.4% of the duration of gestation) was comparable to what was reported in humans (6-22.5% of the duration of gestation) [20]. The tracheal diameter in the baboon fetuses was within the lower range documented for the preterm human fetuses [20] and the dimensions of the balloon used in our experiments were the same as published for human fetuses (7 mm in width and 20 mm in length). In humans, the tracheomegaly could persist up to 5 years postnatally [36,40].…”

Section: Discussionsupporting

confidence: 70%

“…Tracheomegaly has been described in human fetuses undergoing FETO [20,35,36,37]. In humans this effect has been linked to the coexistence of the hypoplastic bronchial tree [38] and the effect of the occlusion itself [36,39].…”

Section: Discussionmentioning

confidence: 99%

“…The images were analyzed after being placed into an IDEXX-PACS Imaging system (IDEXX Laboratories, Inc., Minnesota, Minn., USA). The tracheal width (diameter) was measured at the level of the thoracic inlet just above the carina and at the mid-distance between the above-mentioned points [20]. The combined (average tracheal) width was calculated.…”

Section: Methodsmentioning

confidence: 99%

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A Novel Translational Model of Percutaneous Fetoscopic Endoluminal Tracheal Occlusion - Baboons (Papio spp.)

et al. 2014

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Introduction: Percutaneous fetoscopic endoluminal reversible tracheal occlusion (FETO) was developed to prevent the pulmonary complications of fetal congenital diaphragmatic herniation. There is an urgent need to establish the closest to human translational model of FETO in order to improve fetal outcomes and to determine new clinical approaches and applications. Material and Methods: Seven non-human primates underwent two subsequent surgeries: the first, the FETO in the experimental group (n = 3) or sham operation in the control animals (S-FETO, n = 4) at 132-142 days of gestation (dGA); the second, the reversal of occlusion or sham operation at 162 ± 5 dGA. Maternal stress axis, complete blood count, and biochemical parameters were evaluated and newborn tracheal radiography was performed. Results: The average pregnancy duration and neonatal weights in the FETO group did not differ from the animals in the S-FETO group. There was no bleeding or premature fetal membrane rupture during the procedures in any of the baboons. The maximal tracheal width was 7.02 ± 0.6 mm in the FETO versus 5.46 ± 0.6 mm in S-FETO group. Discussion: This is the very first report of a successful FETO model in non-human primates. Similarities to human tracheomegaly were for the first time documented in any model studied.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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A Novel Translational Model of Percutaneous Fetoscopic Endoluminal Tracheal Occlusion - Baboons (Papio spp.)

et al. 2014

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“…Contudo, essas modificações ainda não foram morfologicamente bem estudadas, nem sua evolução temporal. Radiologicamente foi observada traqueomegalia em lactentes que sobreviveram e tinham sido submetidos à FETO, porém, sem impacto clínico importante além de uma tosse ladrante [49][50][51] . É possível que os efeitos da TO, tanto benéficos como adversos, não se restrinjam apenas aos pulmões e possam se estender à traqueia 32 .…”

Section: História Da Intervenção Fetal E O Diagnóstico Pré-natalunclassified

Manejo pré-natal da hérnia diafragmática congênita: presente, passado e futuro

Gallindo

Gonçalves

Figueira

et al. 2015

Rev. Bras. Ginecol. Obstet.

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Manejo pré-natal da hérnia diafragmática congênita: presente, passado e futuro ResumoA hérnia diafragmática congênita é um defeito de formação do diafragma que acomete entre 1:2.000 e 1:4.000 nascidos vivos e constitui 8% das principais anomalias congênitas. Avanços médicos nos últimos 30 anos envolvendo diagnóstico pré-natal, intervenção fetal, manejo clinico e cirúrgico neonatal têm mudado a sobrevivência dos seus portadores. A evolução histórica desses avanços ajuda a compreender o esforço na busca de melhores resultados desse defeito muitas vezes fatal. Perspectivas na utilização de bioengenharia e terapia envolvendo células tronco podem trazer novas esperanças para os fetos com hérnia diafragmática congênita. AbstractThe congenital diaphragmatic hernia is a defect in the formation of the diaphragm, which affects between 1:2,000 and 1:4,000 live births and represents 8% of major congenital anomalies. Medical advances in the last 30 years involving prenatal diagnosis, fetal intervention, neonatal surgical and clinical management have changed the survival of these patients. The historical evolution of these advances helps us to understand the effort in pursuit of better results of this defect, which is often lethal. Perspectives on the use of bioengineering and therapy involving stem cells may bring new hope for fetuses with congenital diaphragmatic hernia.

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Fetal therapy: progress made and lessons learnt

Nicolaides

Chitty

2011

Prenatal Diagnosis

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Tracheal diameter at birth in severe congenital diaphragmatic hernia treated by fetal endoscopic tracheal occlusion

Abstract: A large number of infants with severe CDH surviving after FETO have a degree of tracheomegaly that is associated with the severity of CDH as assessed by pre-FETO LHR. This tracheomegaly does not constitute an obvious clinical problem.

Cited by 33 publications

References 24 publications

A Novel Translational Model of Percutaneous Fetoscopic Endoluminal Tracheal Occlusion - Baboons (<b><i>Papio</i></b> spp.)

A Novel Translational Model of Percutaneous Fetoscopic Endoluminal Tracheal Occlusion - Baboons (<b><i>Papio</i></b> spp.)

Manejo pré-natal da hérnia diafragmática congênita: presente, passado e futuro

Fetal therapy: progress made and lessons learnt

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