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Childhood cardiac outcome after intrauterine laser treatment of twin–twin transfusion syndrome is favourable
Author(s) -
Halvorsen Cecilia Pegelow,
Mohlkert LillyAnn,
Norman Mikael,
Sonesson SvenErik
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12895
Subject(s) - medicine , twin twin transfusion syndrome , cardiology , cardiac function curve , speckle tracking echocardiography , diastole , circulatory system , doppler echocardiography , cardiac output , singleton , hemodynamics , heart failure , pregnancy , fetus , blood pressure , ejection fraction , genetics , biology
Abstract Aim Intrauterine laser treatment is used to alleviate abnormal circulatory load and cardiac morbidity affecting foetuses with twin–twin transfusion syndrome ( TTTS ). We conducted this childhood follow‐up study to fill the gap in knowledge about final cardiac outcomes after such interventions. Methods We investigated 19 TTTS pairs – 11 male and eight female – with a mean age of four and a half years (range 1.1–9.9) using 2D, blood flow and tissue Doppler, 3D and speckle tracking echocardiography, and compared them with 19 age‐matched and gender‐matched singletons. Results The only observed differences in cardiac structure or function between the donors and recipients were related to diastolic ventricular filling. Recipients had a lower left ventricular ratio of early and late diastolic filling compared with their donor cotwins [1.48(0.35) versus 1.66 (0.28), p < 0.05], but not compared with singleton controls. All observations, except one, were within the reference limits. Speckle tracking could not demonstrate any group differences in systolic ventricular function, besides marginally lower ventricular strain in the donors than controls. Conclusion Double survivors of laser‐treated TTTS showed only minor within‐pair differences in diastolic cardiac function at childhood follow‐up. Cardiac function in TTTS twins compared well to singleton controls, suggesting a favourable long‐term outcome.