A Complication of Percutaneous Sclerotherapy for Congenital Pulmonary Airway Malformation: Intravascular Injection and Cardiac Necrosis

Chon, Andrew H.; Takeda, Moe; Felix, Janine F.; Chmait, Ramen H.

doi:10.1080/15513815.2017.1346017

Cited by 7 publications

(3 citation statements)

References 29 publications

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“…Three additional 2‐mL aliquots were injected without issues, but an IUFD was noted on postoperative day 1. Fetal autopsy findings supported cardiac necrosis most likely secondary to intracardiac circulation of EO as the cause of the IUFD, the details of which have been reported previously . Patient #6 (Table ) had 2 instances of fetal bradycardia in the operating room, one immediately before (100‐110 beats per minute lasting 1 min) and one after surgery (60 beats per minute lasting 5 min).…”

Section: Resultssupporting

confidence: 64%

Types II and III congenital pulmonary airway malformation with hydrops treated in utero with percutaneous sclerotherapy

et al. 2018

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Section: Resultssupporting

confidence: 64%

Types II and III congenital pulmonary airway malformation with hydrops treated in utero with percutaneous sclerotherapy

et al. 2018

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“…Percutaneous sclerotherapy is a minimally invasive therapy compared with fetal surgery, but it may cause fetal demise. [12] Thoracoamniotic shunting is another minimally invasive therapy and the most appropriate treatment for patients presenting with macrocystis. It also had side effects, including rupture of membranes, preterm labor, chorioamnionitis, and repeat shunting secondary to shunt occlusion or displacement.…”

Section: Discussionmentioning

confidence: 99%

Treatment of congenital pulmonary airway malformation with rare high cystic volume ratio: A case report and literature review

Huang,

Gong

2023

Medicine

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Rationale: Congenital pulmonary airway malformation (CPAM) is a rare congenital dysplastic malformation and accounts for 25% of congenital lung lesions. Commonly, it is diagnosed prenatally in ultrasound. The CPAM volume ratio (CVR) is a well-recognized predictor of fetal prognosis, and when the CVR is >1.6 cm2, the fetus is very likely to develop hydrops and even intrauterine deaths. However, the association of CVR with a wide range of complications and neonatal prognosis is unclear. Patient concerns: Cystic lesions in the right thorax of the fetus detected by ultrasound at 19 weeks of gestation, with a CVR of 0.88 cm2. The CVR grew progressively with increasing gestational weeks, reaching a maximum of 5.2 cm2 at 35 gestational weeks. However, there were no complications with the fetus other than polyhydramnios. Diagnosis: Imaging and pathological findings confirmed the diagnosis of CPAM. Interventions: During pregnancy, a multidisciplinary team was involved in the management and the prenatal visits increased to weekly from 31 weeks of gestation. During the cesarean section, neonatologists and pediatric surgeons were present for timely evaluation of newborns. The neonate was admitted to the neonatal intensive care unit for monitoring immediately after birth and underwent thoracoscopic right lower lobectomy at 57th days old. Outcomes: The neonate recovered without any respiratory symptoms and no abnormality on chest computed tomography (CT) at the 3-month postoperative follow-up. Lessons: During pregnancy, in addition to monitoring CVR, a multidisciplinary team should join in the management of CPAM patients. And as for the fetus with increased CVR, a closely monitoring after birth is necessary even if the general condition of the pregnancy is well. In particular, timely intervention should be made at the onset of respiratory symptoms.

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“…La EO inadvertidamente ingresó a la aurícula y ventrículo izquierdo, con posterior bradicardia fetal y fallecimiento. La autopsia reveló necrosis del miocardio (11) . En nuestra serie no hubo casos de óbito fetal por administración del esclerosante fuera de la masa pulmonar.…”

Section: Discussionunclassified

Cirugía fetal en tumores pulmonares mediante escleroterapia

Primera¹,

Guevara

Jiménez³

et al. 2018

Rev peru ginecol obstet.

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Las tumoraciones o masas pulmonares fetales microquísticas, tales como la malformación adenomatoidea quística congénita (CCAM, por sus siglas en inglés) y el secuestro bronco pulmonar (SBP), representan patologías congénitas poco frecuentes, diagnosticadas por ultrasonido durante la evaluación prenatal, con un alto índice de mortalidad de 95% como consecuencia de las complicaciones prenatales por hidropesía y fallecimiento posnatal debido a hipoplasia pulmonar. Las terapias de mínima invasión usando agentes esclerosantes han tomado posicionamiento entre las técnicas de bajo costo y alta efectividad para dichas patologías. Metodología. Se realizó un estudio clínico prospectivo, aleatorio, ciego, en 17 embarazadas con diagnóstico de CCAM microquística o de lesión híbrida (CCAM +SBP) tratadas con betametasona o con polidocanol, optando por la terapia alternativa en caso de fallar la técnica inicial. Resultados. En 4/9 (44,4%) de los 9 casos tratados con betametasona se requirió la terapia alternativa de esclerosis con polidocanol para la resolución del cuadro, que comprometía el estado fetal. La involución de la lesión pulmonar y del cuadro hidrópico fue más rápida y progresiva con la escleroterapia percutánea en comparación con el efecto esteroideo materno. Los resultados perinatales fueron asimismo más satisfactorios en el grupo con polidocanol (91,7%) que en el grupo con el esteroide (60%). Conclusiones. Se comprobó la eficacia de la escleroterapia percutánea con polidocanol para el tratamiento de la CCAM y de lesión híbrida, con resolución más rápida y eficaz de la patología en los casos donde existía resistencia a la terapia esteroidea previamente administrada.

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A Complication of Percutaneous Sclerotherapy for Congenital Pulmonary Airway Malformation: Intravascular Injection and Cardiac Necrosis

Abstract: Percutaneous sclerotherapy has been previously described in the literature for the treatment of microcystic CPAMs with secondary hydrops. This is the first reported case of an adverse event after fetal sclerotherapy.

Cited by 7 publications

References 29 publications

Types II and III congenital pulmonary airway malformation with hydrops treated in utero with percutaneous sclerotherapy

Types II and III congenital pulmonary airway malformation with hydrops treated in utero with percutaneous sclerotherapy

Treatment of congenital pulmonary airway malformation with rare high cystic volume ratio: A case report and literature review

Cirugía fetal en tumores pulmonares mediante escleroterapia

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