Birth prevalence of right ventricular outflow tract abnormalities in the recipient twin of monochorionic twin pregnancies complicated by twin-to-twin transfusion syndrome: amnioreduction versus foetoscopic laser coagulation treatment

Faiola, S.; Casati, D.; Laoreti, A.; Corti, C.; Bianchi, S.; Stellio, Leonardo Nelva; Cetin, I.; Lanna, M.

doi:10.36129/jog.2022.48

Cited by 1 publication

(1 citation statement)

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“…However, treatment with FLS can ensure the regression of functional RVOTAs before they become organic. This is thoroughly demonstrated by the finding in our recent publication that RVOTA incidence at birth in RTs was halved in the FLS group compared with a TTTS group that was treated before 2004 with amnioreduction (4.5% vs. 9.4%, respectively) [18].…”

Section: Discussionmentioning

confidence: 79%

Long-Term Postnatal Follow-Up in Monochorionic TTTS Twin Pregnancies Treated with Fetoscopic Laser Surgery and Complicated by Right Ventricular Outflow Tract Anomalies

Faiola

Mandalari

Coco

et al. 2023

JCM

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Right ventricular outflow tract anomalies (RVOTAs), such as pulmonary stenosis (PS), pulmonary atresia (PA), and pulmonary insufficiency (PI), are typical cardiac anomalies in monochorionic twins, and they are complicated by twin-to-twin transfusion syndrome (TTTS). The aim of this study was to conduct a long-term postnatal cardiological evaluation of prenatal RVOTAs in monochorionic diamniotic twin pregnancies complicated by TTTS and treated with fetoscopic laser surgery (FLS) and to analyze possible prenatal predictors of congenital heart disease (CHD). Prenatal RVOTAs were retrospectively retrieved from all TTTS cases treated with FLS in our unit between 2009 and 2019. Twenty-eight prenatal cases of RVOTAs (16 PI, 10 PS, 2 PA) were observed out of 335 cases of TTTS. Four cases did not reach the postnatal period. CHD was present in 17 of the remaining 24 cases (70.8%), with 10 being severe (58.8%; 10/17); nine cases of PS required balloon valvuloplasty, and one case required biventricular non-compaction cardiomyopathy. The risk of major CHD increased with prenatal evidence of PS and decreased with the gestational age at the time of TTTS and with the prenatal normalization of blood flow across the pulmonary valve. Despite treatment with FLS, the majority of monochorionic diamniotic twin pregnancies complicated by TTTS with prenatal RVOTAs had CHD at long-term follow-up.

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Section: Discussionmentioning

confidence: 79%