Percutaneous Intrauterine Laser Ablation of the Abnormal Vessel in Pulmonary Sequestration With Hydrops at 29 Weeks' Gestation

Ruano, Rodrigo; Pimenta, E.; Silva, Marcos Marques da; Maksoud, João Gilberto; Zugaib, Marcelo

doi:10.7863/jum.2007.26.9.1235

Cited by 31 publications

(34 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While all previously reported cases with complete cessation of flow after successful VLA showed regression of tumor size at follow-up examinations [4,15,16], those with persistent residual flow did not, and postnatal sequestrectomy was required [5,17]. In accordance with the mentioned studies, pleural effusions dissolved as well as tumor size decreased in all our cases (100%), once complete cessation of blood flow in the feeding vessel was achieved.…”

Section: Discussionsupporting

confidence: 72%

“…The most common interventions nowadays are pleuroamniotic shunting [4,5,13,14] and, more recently, the intrafetal percutaneous vascular laser ablation of the feeding vessel (VLA), as described above [4,5,8,[15][16][17]21]. While pleuroamniotic shunting only targets the symptoms of BPS and does not lead to a reduction in size, the incidence of postnatal surgery was high, with 87.5% of newborns requiring sequestrectomy [4,5,13,14].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcome of Bronchopulmonary Sequestration with Massive Pleural Effusion after Intrafetal Vascular Laser Ablation

Gottschalk¹,

Strizek²,

Mallmann³

et al. 2017

Fetal Diagn Ther

View full text Add to dashboard Cite

Objective: To assess the outcome of 12 fetuses with bronchopulmonary sequestration (BPS) and massive pleural effusion after intrafetal vascular laser ablation (VLA). Methods: All fetuses with BPS and massive pleural effusion that were treated with intrafetal VLA during a 5-year period (2012-2016) were reviewed for safety, intrauterine course, and postnatal outcome. Results: In the study period, 12 fetuses with BPS were treated with VLA. In 7 (58.3%) fetuses, complete cessation of blood flow was achieved after the first VLA, while in 5 (41.7%) fetuses, residual perfusion of the feeding vessel was demonstrated at follow-up. A second intervention was successful in 4 of 5 (80%) fetuses. Overall, in 11 of 12 (91.7%) fetuses, complete coagulation of the feeding vessel could be achieved, followed by a reduction in size or complete resolution of the BPS. All 11 fetuses with successful prenatal intervention were live-born at a median gestational age of 39⁺¹ (range, 37⁺⁵-41⁺²) weeks. Postnatally, 2 (18.2%) of the 11 newborns underwent sequestrectomy, as well as the preterm newborn on which a second fetal intervention was not feasible. Conclusion: VLA is an effective and safe treatment of BPS that appears to be of benefit in improving prognosis and decreasing the need for postnatal sequestrectomy.

show abstract

Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Outcome of Bronchopulmonary Sequestration with Massive Pleural Effusion after Intrafetal Vascular Laser Ablation

Gottschalk¹,

Strizek²,

Mallmann³

et al. 2017

Fetal Diagn Ther

View full text Add to dashboard Cite

show abstract

“…Preliminary evidence supports a potential benefit of fetal laser ablation of the feeding artery to improve survival and decrease the need of postnatal surgery [3,[5][6][7][8][9][10][11]. However, the prenatal evolution of fetal fluid effusions and the longitudinal intrathoracic changes after fetal surgery have not been previously evaluated.…”

Section: Introductionmentioning

confidence: 99%

Thoracic Changes after Full Laser Ablation of the Feeding Artery in Fetuses with Bronchopulmonary Sequestration

Cruz‐Martínez

Nieto-Castro²,

Martínez‐Rodríguez³

et al. 2017

Fetal Diagn Ther

View full text Add to dashboard Cite

Objective: To assess longitudinal intrathoracic changes after fetal laser surgery in fetuses with bronchopulmonary sequestration (BPS) with hydrops and/or hydrothorax. Study Design: The presence of intrafetal fluid effusions, the lung mass volume ratio (congenital pulmonary airway malformation volume ratio [CVR]), and the observed/expected lung-to-head circumference ratio (O/E-LHR) of both lungs were evaluated in a cohort of BPS fetuses with hydrops and/or hydrothorax treated with full laser ablation of the feeding artery (FLAFA). The longitudinal changes in intrafetal fluid effusions, lung mass volume, and pulmonary growth were analyzed by survival and multilevel analysis against days after FLAFA. Results: FLAFA was successfully performed in 15 cases at a median gestational age of 26.9 weeks. A complete disappearance of the hydrops and hydrothorax was observed a median interval of 7.5 and 21 days after the fetal intervention, respectively. A progressive decrease in the CVR and an increment in the size of both lungs were observed after FLAFA. The O/E-LHR of the lung contralateral and ipsilateral to the side of the BPS became normal on average 8 and 10 weeks after FLAFA, respectively. Conclusion: Fetal laser surgery with FLAFA promotes disappearance of all fetal fluid effusions, a lung mass regression sequence, and a normalization of pulmonary growth.

show abstract

“…Complete disruption of blood flow to the lung mass appears to be critical to the success of this fetal intervention. While cases with no residual blood flow after surgery showed regression of the lung mass during fetal follow-up 2 -4 , those with blood supply remaining did not and postnatal sequestrectomy was required 1,5 . Our findings support the use of FLAFA as a therapeutic option for fetuses with BPS complicated by hydrops and/or massive pleural effusion.…”

mentioning

confidence: 99%

Fetal laser surgery prevents fetal death and avoids the need for neonatal sequestrectomy in cases with bronchopulmonary sequestration

Cruz‐Martínez

Méndez

Dueñas-Riaño³

et al. 2015

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

Percutaneous Intrauterine Laser Ablation of the Abnormal Vessel in Pulmonary Sequestration With Hydrops at 29 Weeks' Gestation

Cited by 31 publications

References 25 publications

Outcome of Bronchopulmonary Sequestration with Massive Pleural Effusion after Intrafetal Vascular Laser Ablation

Outcome of Bronchopulmonary Sequestration with Massive Pleural Effusion after Intrafetal Vascular Laser Ablation

Thoracic Changes after Full Laser Ablation of the Feeding Artery in Fetuses with Bronchopulmonary Sequestration

Fetal laser surgery prevents fetal death and avoids the need for neonatal sequestrectomy in cases with bronchopulmonary sequestration

Contact Info

Product

Resources

About