title: Twin-twin transfusion syndrome treated with laser surgery: postnatal prevalence of congenital heart disease in surviving recipients and donors.
abstract: OBJECTIVE
  To assess postnatal prevalence of congenital heart disease (CHD) in surviving twins treated for twin-twin transfusion syndrome (TTTS) with laser surgery.
  
  
  METHODS
  Patients who underwent laser surgery for TTTS at a single institution were prospectively enrolled between January 2009 and May 2010. Preoperative fetal echocardiography was performed. Perinatal outcomes were obtained via postnatal echocardiograms and review of medical records. CHD was defined as unequivocal structural cardiac pathology; patent foramen ovale and patent ductus arteriosus were excluded.
  
  
  RESULTS
  Fifty pregnancies with TTTS were enrolled, with the following Quintero stage distribution: stage I, 10%; stage II, 22%; stage III, 50%; and stage IV, 18%. Of the 88 fetuses born alive, 84 patients (95.5%) completed postnatal cardiac evaluation. Overall postnatal prevalence of CHD was 15.5% (13 of 84): 15.6% of recipient twins and 15.4% of donor twins. Three patients required cardiac intervention during infancy. Among liveborn twins with CHD, the overall prenatal detection rate was 30.8% (4/13), comprising 16.7% (1/6) of donors compared with 42.9% (3/7) of recipients.
  
  
  CONCLUSIONS
  Following successful laser surgery for TTTS, an increased and comparable postnatal prevalence of CHD occurs among both former recipients and donors.
authors: Division of Pediatric Cardiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA. jpruetz@chla.usc.edu
authors: Jay D
authors: JD
authors: Pruetz
authors: Mark
authors: M
authors: Sklansky
authors: Jon
authors: J
authors: Detterich
authors: Lisa M
authors: LM
authors: Korst
authors: Arlyn
authors: A
authors: Llanes
authors: Ramen H
authors: RH
authors: Chmait
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D004452:Echocardiography / Q000379:methods; D005260:Female; D005330:Fetofetal Transfusion / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000209:etiology* / Q000401:mortality; D006801:Humans; D007231:Infant, Newborn; D017075:Laser Coagulation / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D015995:Prevalence; D011446:Prospective Studies; D015996:Survival Rate; D014427:Twins; D016216:Ultrasonography, Prenatal