Endoscopic tracheal obstruction with an expanding device in a fetal lamb model: preliminary considerations.
Tracheal obstruction to promote lung growth may be a less aggressive alternative to open fetal surgery in the antenatal treatment of congenital diaphragmatic hernia. Herein, we explore the feasibility of placing an occluding device through fetal tracheoscopy. A self-expanding umbrella allowed adequate sealing of the tracheal lumen even as the tracheal diameter more than doubled between 110 and 138 days of gestation (term = 145 days) in a sheep model. Distal intratracheal pressures after umbrella placement, and lung weight at delivery, were comparable to those after formal tracheal ligation.
Luks
F I
FI
Department of Surgery, Brown University School of Medicine, Providence, RI 02903, USA.
Gilchrist
B F
BF
Jackson
B T
BT
Piasecki
G J
GJ
D000818:Animals; D004195:Disease Models, Animal; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005315:Fetal Diseases / Q000601:surgery*; D006548:Hernia, Diaphragmatic / Q000150:complications / Q000601:surgery*; D065630:Hernias, Diaphragmatic, Congenital; D011247:Pregnancy; D012756:Sheep; D014135:Tracheal Stenosis / Q000209:etiology* / Q000473:pathology