Sequential laser surgery for twin-twin transfusion syndrome

Ramen H. Chmait, Eftichia V. Kontopoulos, Rubén A. Quintero

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations

Abstract

Treatment of twin-twin transfusion syndrome (TTTS) via the sequential selective laser photocoagulation of communicating vessels (SQLPCV) technique involves lasering the arteriovenous communications from the donor twin to the recipient twin first, followed by the arteriovenous communications from the recipient twin to the donor. Occluding the vascular communications in this particular order may result in transient intraoperative net transfusion to the donor twin and facilitate hemodynamic equilibrium, particularly to the volume depleted donor twin. Preliminary evidence suggests that the SQLPCV technique may result in improved perinatal outcomes compared with the standard selective (SLPCV) laser surgical approach. In this article, we describe the pathophysiological basis for this surgical approach, delineate the surgical technique, review the literature, and elaborate on the outstanding questions of the SQLPCV treatment of TTTS.

Original languageEnglish (US)
Pages (from-to)S13-S18
JournalAmerican Journal of Perinatology
Volume31
Issue numberSUPPL. 1
DOIs
StatePublished - Sep 2014

Keywords

  • laser photocoagulation of communicating vessels
  • laser surgery
  • operative fetoscopy
  • TTTS
  • twin-twin transfusion syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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