Twin-twin transfusion syndrome treated with laser surgery: postnatal prevalence of congenital heart disease in surviving recipients and donors

Prenat Diagn. 2011 Oct;31(10):973-7. doi: 10.1002/pd.2818. Epub 2011 Jul 11.

Abstract

Objective: To assess postnatal prevalence of congenital heart disease (CHD) in surviving twins treated for twin-twin transfusion syndrome (TTTS) with laser surgery.

Methods: Patients who underwent laser surgery for TTTS at a single institution were prospectively enrolled between January 2009 and May 2010. Preoperative fetal echocardiography was performed. Perinatal outcomes were obtained via postnatal echocardiograms and review of medical records. CHD was defined as unequivocal structural cardiac pathology; patent foramen ovale and patent ductus arteriosus were excluded.

Results: Fifty pregnancies with TTTS were enrolled, with the following Quintero stage distribution: stage I, 10%; stage II, 22%; stage III, 50%; and stage IV, 18%. Of the 88 fetuses born alive, 84 patients (95.5%) completed postnatal cardiac evaluation. Overall postnatal prevalence of CHD was 15.5% (13 of 84): 15.6% of recipient twins and 15.4% of donor twins. Three patients required cardiac intervention during infancy. Among liveborn twins with CHD, the overall prenatal detection rate was 30.8% (4/13), comprising 16.7% (1/6) of donors compared with 42.9% (3/7) of recipients.

Conclusion: Following successful laser surgery for TTTS, an increased and comparable postnatal prevalence of CHD occurs among both former recipients and donors.

MeSH terms

  • Adult
  • California / epidemiology
  • Echocardiography / methods
  • Female
  • Fetofetal Transfusion / complications*
  • Fetofetal Transfusion / mortality
  • Fetofetal Transfusion / surgery*
  • Gestational Age
  • Heart Defects, Congenital / etiology*
  • Heart Defects, Congenital / mortality
  • Humans
  • Infant, Newborn
  • Laser Coagulation / methods*
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy, Multiple
  • Prevalence
  • Prospective Studies
  • Survival Rate
  • Twins*
  • Ultrasonography, Prenatal