Prevalence of right ventricular outflow tract abnormalities among recipients in twin-twin transfusion syndrome after fetoscopic laser surgery in 90 consecutive cases
Prevalence of right ventricular outflow tract abnormalities among recipients in twin-twin transfusion syndrome after fetoscopic laser surgery in 90 consecutive cases
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DOI：
10.1007/s10396-019-00982-y
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发表时间：
2019-10-22
影响因子：
1.8
通讯作者：
Sugino, Norihiro
中科院分区：
文献类型：
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作者：
Murata, Susumu;Nakata, Masahiko;Sugino, Norihiro
目的右心室流出道梗阻（RVOTO）是双胎输血综合征（TTTS）受者的严重并发症。本研究调查的患病率RVOTO在TTTS激光手术后，并检查RVOTO的危险因素。MethodsThis回顾性研究评估了90例谁经历了激光手术，并在出生后6个月随访。RVOTO的诊断是基于出生后的超声心动图结果。超声和临床记录，包括产妇和新生儿的数据，从我们的数据库中检索。发展RVOTO的危险因素进行了比较，受体与无RVOTO在一个统计analysis.Results6存活受体被诊断为RVOTO。3例受者发生了严重的肺动脉狭窄（PS），需要经皮腔内肺动脉瓣成形术或球囊肺动脉成形术。共有6.7%的受体（6/90）患有RVOTO，包括PS和三尖瓣返流（TR），3.3%的受体（3/90）需要侵入性治疗。的特征因素并没有显着差异受体与无RVOTO.ConclusionThis研究显示，6.7%的TTTS受体PS，和3.3%需要侵入性治疗PS。然而，受体RVOTO的发生与母体临床数据和胎儿超声检查结果之间无显著相关性。仅使用术前超声和临床信息很难预测受体RVOTO的发展。
PurposeRight ventricular outflow tract obstruction (RVOTO) is a severe complication in recipients in twin-twin transfusion syndrome (TTTS). This study investigated the prevalence of RVOTO in TTTS after laser surgery and examined the risk factors for RVOTO.MethodsThis retrospective study evaluated 90 patients who had undergone laser surgery and been followed for 6 months after birth. The diagnosis of RVOTO was made based on postnatal echocardiography findings. Ultrasound and clinical records, including maternal and neonatal data, were retrieved from our database. Risk factors for developing RVOTO were compared between recipients with and without RVOTO in a statistical analysis.ResultsSix surviving recipients were diagnosed with RVOTO. Three recipients had developed severe pulmonary stenosis (PS) that required percutaneous transluminal pulmonary valvuloplasty or balloon pulmonary angioplasty. A total of 6.7% of recipients (6/90) had RVOTO, consisting of PS and tricuspid regurgitation (TR), and 3.3% of recipients (3/90) required invasive treatment. The characteristic factors did not differ significantly between recipients with and without RVOTO.ConclusionThis study revealed that 6.7% of recipients with TTTS had PS, and 3.3% required invasive treatment for PS. However, no significant association was noted between RVOTO development in recipients and maternal clinical data and fetal ultrasound examination findings. It is difficult to predict RVOTO development in recipients using only preoperative ultrasound and clinical information.