title: Assessment of fetal cardiac function before and after therapy for twin-to-twin transfusion syndrome.
abstract: OBJECTIVE
  We sought to assess fetal cardiac function in monochorionic twins before and after therapy for twin-to-twin transfusion syndrome (TTTS) and compare it with control subjects.
  
  
  METHODS
  We conducted prospective longitudinal assessment of fetal cardiac function in cases undergoing curative fetal therapy for TTTS (n = 39) until 4 weeks postoperatively and in uncomplicated monochorionic twins (n = 23). Fetal cardiac function was assessed by the left and right ventricular myocardial performance index, atrioventricular valve flow pattern, ductus venosus a-wave, and umbilical vein pulsations.
  
  
  RESULTS
  Nomograms for the myocardial performance index were constructed. Fetal cardiac function was grossly abnormal in recipient twins of TTTS when compared with control subjects (P < .001 for all indices) but normalized by 4 weeks postoperatively. The donor developed abnormal ductus venosus flow and tricuspid regurgitation postoperatively that regressed within 4 weeks.
  
  
  CONCLUSIONS
  The cardiac dysfunction in the recipient twin of TTTS normalizes within 1 month after laser. The donor develops a transient impairment of cardiac function postoperatively.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Tim
authors.initials: T
authors.lastname: Van Mieghem
authors.forename: Philipp
authors.initials: P
authors.lastname: Klaritsch
authors.forename: Elisa
authors.initials: E
authors.lastname: Doné
authors.forename: Léonardo
authors.initials: L
authors.lastname: Gucciardo
authors.forename: Paul
authors.initials: P
authors.lastname: Lewi
authors.forename: Johan
authors.initials: J
authors.lastname: Verhaeghe
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Lewi
authors.forename: Jan
authors.initials: J
authors.lastname: Deprest