Percutaneous fetoscopic laser decompression of congenital high airway obstruction syndrome (CHAOS) from laryngeal atresia via a single trocar--current technical constraints and potential solutions for future interventions.
OBJECTIVE
To alleviate congenital high airway obstruction syndrome (CHAOS) from laryngeal atresia by percutaneous minimally-invasive fetoscopic tracheal decompression using laser.


METHODS
The procedure was performed via one trocar under general maternofetal anesthesia in a human fetus with CHAOS from laryngeal atresia at 21+6 weeks of gestation.


RESULTS
Normalization of the lung-heart size relationship was observed within days after the procedure. The fetus was delivered by ex utero intrapartum treatment (EXIT) in order to perform a tracheotomy at 31+1 weeks of gestation and survived hospital treatment to discharge.


CONCLUSIONS
Percutaneous minimally-invasive fetoscopic decompression of the fetal trachea via a single trocar is feasible in human fetuses with CHAOS from laryngeal atresia.
Kohl
Thomas
T
Department of Obstetrics and Prenatal Medicine, German Center for Fetal Surgery and Minimally-Invasive Therapy, Bonn, Germany. thomas.kohl@ukb.uni-bonn.de
Van de Vondel
Patricia
P
Stressig
Rüdiger
R
Wartenberg
Hans C
HC
Heep
Axel
A
Keiner
Sabine
S
Müller
Andreas
A
Franz
Axel
A
Fröhlich
Susanne
S
Willinek
Winfried
W
Gembruch
Ulrich
U
D000328:Adult; D000402:Airway Obstruction / Q000151:congenital / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D005315:Fetal Diseases / Q000209:etiology / Q000601:surgery*; D005332:Fetoscopy / Q000379:methods; D005333:Fetus / Q000601:surgery; D006801:Humans; D007818:Laryngeal Diseases / Q000150:complications* / Q000601:surgery; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D011247:Pregnancy; D013525:Surgical Instruments; D013577:Syndrome; D014132:Trachea / Q000000981:diagnostic imaging / Q000601:surgery*; D016216:Ultrasonography, Prenatal