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Assessment of cardiac function in donor and recipient fetuses during a 7-day follow-up after selective laser photocoagulation of communicating vessels due to TTTS
- Medical University of Gdansk, Department of Obstetrics, Gdansk, Poland
- Medical University of Gdansk, Department of Pediatric Cardiology and Congenital Heart Diseases, Gdansk, Poland
- Copernicus Hospital in Gdansk, Department of Pediatric Cardiac Surgery, Gdansk, Poland
- Gdansk University of Physical Education and Sport, Chair of Physiotherapy, Gdansk, Poland
- Medical University of Gdansk, Department of Rehabilitation, Gdansk, Poland
open access
Abstract
Objectives: The aim of the study was to analyze the changes in cardiac function and myocardial contractility of donor and recipient fetuses with twin-to-twin transfusion syndrome (TTTS) subjected to selective laser photocoagulation of the communicating vessels (SLPCV), between and after the procedure. Finally, we verified if fetuses with Quintero’s stage I TTTS presented with early impairment of myocardial contractility.
Material and methods: We selected 77 consecutive women with twin pregnancies, whose both fetuses survived at least seven days post-SLPCV. Myocardial contractility of both fetuses was evaluated ultrasonographically, and their myocardial performance indices (Tei-Index values) and shortening fractions (SF) were determined.
Results: In donor fetuses, the Tei-Index values for both right and left ventricle remained within the respective reference ranges both before the procedure and during a 7-day follow-up. A significant change in shortening fraction values for the left ventricle in recipient fetuses and the right ventricle of in the donors was observed during a 7-day follow-up.
Conclusions: Comparison of the cardiac parameters of donors and recipients revealed significant differences in Tei-indices during the entire follow-up period.
The group with Quintero’s I stage TTTS included 74% of recipient fetuses with abnormal Tei-Index values for the right ventricle (mean 0.53).
Abstract
Objectives: The aim of the study was to analyze the changes in cardiac function and myocardial contractility of donor and recipient fetuses with twin-to-twin transfusion syndrome (TTTS) subjected to selective laser photocoagulation of the communicating vessels (SLPCV), between and after the procedure. Finally, we verified if fetuses with Quintero’s stage I TTTS presented with early impairment of myocardial contractility.
Material and methods: We selected 77 consecutive women with twin pregnancies, whose both fetuses survived at least seven days post-SLPCV. Myocardial contractility of both fetuses was evaluated ultrasonographically, and their myocardial performance indices (Tei-Index values) and shortening fractions (SF) were determined.
Results: In donor fetuses, the Tei-Index values for both right and left ventricle remained within the respective reference ranges both before the procedure and during a 7-day follow-up. A significant change in shortening fraction values for the left ventricle in recipient fetuses and the right ventricle of in the donors was observed during a 7-day follow-up.
Conclusions: Comparison of the cardiac parameters of donors and recipients revealed significant differences in Tei-indices during the entire follow-up period.
The group with Quintero’s I stage TTTS included 74% of recipient fetuses with abnormal Tei-Index values for the right ventricle (mean 0.53).
Keywords
SLPCV; donor; recipient; heart assessment; laser photocoagulation; Tei-Index
Title
Assessment of cardiac function in donor and recipient fetuses during a 7-day follow-up after selective laser photocoagulation of communicating vessels due to TTTS
Journal
Issue
Article type
Research paper
Pages
189-194
Published online
2019-04-29
Page views
2011
Article views/downloads
1113
DOI
Pubmed
Bibliographic record
Ginekol Pol 2019;90(4):189-194.
Keywords
SLPCV
donor
recipient
heart assessment
laser photocoagulation
Tei-Index
Authors
Katarzyna Leszczynska
Jaroslaw Meyer-Szary
Maciej Chojnicki
Ireneusz Haponiuk
Krzysztof Preis
Katarzyna Stefanska
Katarzyna Gierat-Haponiuk
Malgorzata Swiatkowska-Freund
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