title: Childhood cardiac outcome after intrauterine laser treatment of twin-twin transfusion syndrome is favourable.
abstract: OBJECTIVE
  Intrauterine laser treatment is used to alleviate abnormal circulatory load and cardiac morbidity affecting foetuses with twin-twin transfusion syndrome (TTTS). We conducted this childhood follow-up study to fill the gap in knowledge about final cardiac outcomes after such interventions.
  
  
  METHODS
  We investigated 19 TTTS pairs - 11 male and eight female - with a mean age of four and a half years (range 1.1-9.9) using 2D, blood flow and tissue Doppler, 3D and speckle tracking echocardiography, and compared them with 19 age-matched and gender-matched singletons.
  
  
  RESULTS
  The only observed differences in cardiac structure or function between the donors and recipients were related to diastolic ventricular filling. Recipients had a lower left ventricular ratio of early and late diastolic filling compared with their donor cotwins [1.48(0.35) versus 1.66 (0.28), p < 0.05], but not compared with singleton controls. All observations, except one, were within the reference limits. Speckle tracking could not demonstrate any group differences in systolic ventricular function, besides marginally lower ventricular strain in the donors than controls.
  
  
  CONCLUSIONS
  Double survivors of laser-treated TTTS showed only minor within-pair differences in diastolic cardiac function at childhood follow-up. Cardiac function in TTTS twins compared well to singleton controls, suggesting a favourable long-term outcome.
authors.affiliation: Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Cecilia Pegelow
authors.initials: CP
authors.lastname: Halvorsen
authors.forename: Lilly-Ann
authors.initials: LA
authors.lastname: Mohlkert
authors.forename: Mikael
authors.initials: M
authors.lastname: Norman
authors.forename: Sven-Erik
authors.initials: SE
authors.lastname: Sonesson
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003971:Diastole / Q000502:physiology; D005260:Female; D005330:Fetofetal Transfusion / Q000601:surgery*; D005332:Fetoscopy; D005500:Follow-Up Studies; D006321:Heart / Q000502:physiology*; D006801:Humans; D007223:Infant; D017075:Laser Coagulation / Q000379:methods; D008297:Male; D011247:Pregnancy; D013599:Systole / Q000502:physiology; D016896:Treatment Outcome
keywords: Cardiac function; Foetal therapy; Follow-up study; Twin transfusion