title: In-utero radiofrequency ablation in fetal piglets: Lessons learned.
abstract: BACKGROUND
  Radiofrequency ablation (RFA) is increasingly utilized in minimally invasive fetal intervention. However, the response of different fetal tissues to RFA is poorly characterized. We sought to determine the extent of RFA damage in a fetal environment.
  
  
  METHODS
  90Day gestation Yorkshire piglets (term 115days) were subjected to RFA of the chest and abdominal viscera under various temperatures and wattages. The extent of tissue damage was determined by NADPH diaphorase histochemistry.
  
  
  RESULTS
  Tyne temperature was widely variable and displayed varying responses between lung and liver tissue. Tyne exposure to amniotic fluid resulted in an increase in amniotic fluid temperature. Collateral damage, even across the diaphragm, was readily seen, and ultrasonography did not always reflect this injury.
  
  
  CONCLUSIONS
  Utilization of extracorporeal tynes heats fluid at a greater rate than solid tissue and reliance on temperature sensitive probes may result in overheating. The extent of injury may extend beyond damage observed by ultrasound examination and varies for different tissues. Additional studies on the use of devices that regulate tyne temperature are needed to define optimal conditions and better define the extent of adjacent tissue injury.
authors: Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA; Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA. Electronic address: oolutoye@bcm.edu.
authors: Oluyinka O
authors: OO
authors: Olutoye
authors: Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA; Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors: Andre N
authors: AN
authors: Gay
authors: Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA; Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors: Fariha
authors: F
authors: Sheikh
authors: Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA; Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors: Adesola C
authors: AC
authors: Akinkuotu
authors: Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA; Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors: Miel
authors: M
authors: Sundararajan
authors: Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA; Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors: David A
authors: DA
authors: Lazar
authors: Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA; Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors: Irving J
authors: IJ
authors: Zamora
authors: Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA; Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors: Bindi J
authors: BJ
authors: Naik-Mathuria
authors: Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA; Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors: Darrell L
authors: DL
authors: Cass
authors: Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA; Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors: Ling
authors: L
authors: Yu
mesh_terms: D000653:Amniotic Fluid / Q000502:physiology; D000818:Animals; D001831:Body Temperature; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D046128:Fetal Therapies / Q000009:adverse effects / Q000379:methods*; D008099:Liver / Q000196:embryology / Q000473:pathology / Q000601:surgery*; D008168:Lung / Q000196:embryology / Q000473:pathology / Q000601:surgery*; D011247:Pregnancy; D013552:Swine; D016216:Ultrasonography, Prenatal
keywords: Fetal surgery; Fetus; Radiofrequency ablation; Tumor; Yorkshire pig