Acute effects of selective fetoscopic laser photocoagulation on recipient cardiac function in twin-twin transfusion syndrome.
OBJECTIVE
This study evaluated the acute effects of selective fetoscopic laser photocoagulation (SFLP) on recipient cardiovascular function in a twin-twin transfusion syndrome (TTTS) pregnancy.


METHODS
This was a retrospective chart review of echocardiographic data in TTTS including right (RV) and left (LV) ventricular Doppler myocardial performance index (MPI); LV and RV end diastolic wall thickness; and umbilical artery (UA), vein (UV), and ductus venosus (DV) Dopplers. The primary outcome measures were improved MPI defined as greater than 10% interval decrease in left and/or right MPI. Data were analyzed by Student t test and Fisher's exact test.


RESULTS
Sixty-five patients met inclusion criteria. SFLP results in a significant improvement in UV and DV Doppler and an increase in both RV and LV wall thickness. A 10% or greater improvement in recipient LV MPI after SFLP is associated with improved recipient survival as compared with unimproved LV MPI (100% vs 86.1%, P = .05).


CONCLUSIONS
Improved recipient myocardial performance index after SFLP is associated with improvement in recipient survival.
Habli
Mounira
M
Fetal Care Center of Cincinnati, Cincinnati Children's Hospital, Cincinnati, OH 45229-3039, USA.
Michelfelder
Erik
E
Livingston
Jeffrey
J
Harmon
Jeffrey
J
Lim
Foong Yen
FY
Polzin
William
W
Crombleholme
Timothy
T
D000328:Adult; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D005332:Fetoscopy / Q000379:methods*; D006801:Humans; D017075:Laser Coagulation; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D014690:Venous Pressure; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right