Ramesha Papanna1, Lovepreet K Mann, Saulo Molina, Anthony Johnson, Kenneth J Moise. 1. Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine and the Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA. rpapanna@gmail.com
Abstract
OBJECTIVE: To assess serial changes in the Tei index of the recipient fetus secondary to fetoscopic laser photocoagulation of placental anastomoses (FLP) for twin-twin transfusion syndrome (TTTS) during the peri-operative period. STUDY DESIGN: A prospective study of cases that underwent FLP at the Texas Children's Fetal Center was performed. Mean and individual changes in the Tei index measurements were obtained during the pre-operative, intra-operative and the post-operative (12-h and 24-h) periods after surgery and were compared using paired t-test. A p-value of < 0.05 was considered as significant. RESULTS: A total of 20 patients were included in the study. In both the right and the left side, the mean Tei indices appeared to be increased from baseline during the intra-operative period, with a subsequent decrease to pre-operative values within 24 h of laser surgery. These changes were also noted when individualized patient results were analyzed in a serial fashion. CONCLUSION: FLP results in a transient increase in the intra-operative myocardial performance index in the recipient fetus. These changes appear to resolve in the post-operative period.
OBJECTIVE: To assess serial changes in the Tei index of the recipient fetus secondary to fetoscopic laser photocoagulation of placental anastomoses (FLP) for twin-twin transfusion syndrome (TTTS) during the peri-operative period. STUDY DESIGN: A prospective study of cases that underwent FLP at the Texas Children's Fetal Center was performed. Mean and individual changes in the Tei index measurements were obtained during the pre-operative, intra-operative and the post-operative (12-h and 24-h) periods after surgery and were compared using paired t-test. A p-value of < 0.05 was considered as significant. RESULTS: A total of 20 patients were included in the study. In both the right and the left side, the mean Tei indices appeared to be increased from baseline during the intra-operative period, with a subsequent decrease to pre-operative values within 24 h of laser surgery. These changes were also noted when individualized patient results were analyzed in a serial fashion. CONCLUSION: FLP results in a transient increase in the intra-operative myocardial performance index in the recipient fetus. These changes appear to resolve in the post-operative period.
Authors: Christine E MacColl; Cedric Manlhiot; Christiana Page; Brian W McCrindle; Steven E S Miner; Edgar T Jaeggi; Lynne E Nield Journal: Pediatr Cardiol Date: 2014-06-14 Impact factor: 1.655