Laser Aids Biventricular Systolic Function in Twin-Twin Syndrome
Selective laser ablation also tends to boost diastolic function in recipient twin
THURSDAY, Nov. 9 (HealthDay News) -- Selective laser ablation improves the cardiovascular pathology of the recipient twin in twin-twin transfusion syndrome, according to the results of a new study published in the November issue of the American Journal of Obstetrics & Gynecology.
Catherine Barrea, M.D., of the Hospital for Sick Children in Toronto, Canada, and colleagues treated 37 patients with severe twin-twin transfusion syndrome with selective laser ablation of placental anastomoses. Of these, 35 underwent fetal echocardiography and 22 had an echocardiogram before and after the laser procedure. Before laser, all but one patient had cardiomegaly and right ventricular systolic dysfunction was present in 59 percent of patients, while left ventricular systolic dysfunction occurred in 27 percent.
There were significant improvement in right ventricular and left ventricular function and a reduction in tricuspid regurgitation shortly after laser. In addition, diastolic function tended to improve. The researchers suggest this contributed to a resolution of fetal hydrops and a reduction in the incidence of anatomical right ventricular outflow tract obstruction.
"These observations provide further insight into the pathogenesis of the cardiovascular pathology in recipient twins and the underlying pathophysiology of twin-twin transfusion syndrome," the study authors conclude.