{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T10:45:18Z","timestamp":1768473918249,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T00:00:00Z","timestamp":1643241600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To develop and test a novel vesicoamniotic shunt (VAS) to treat fetal lower urinary tract obstruction (LUTO), decrease dislodgement and optimize shunt deployment in\u2010vitro.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Vesicoamniotic shunt design objectives included: (1) robust and atraumatic fixation elements, (2) kink resistant conduit to adjust to fetal movement and growth, (3) one\u2010way pressure valve to facilitate bladder cycling, and (4) echogenic deployment visualization aids. The force to dislodge the novel Vortex shunt was compared with existing commercially available shunts in a bench\u2010top porcine bladder model. Sonographic echogenicity was evaluated with ultrasound\u2010guided deployment, and the shunt valve pressure measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A prototype novel Vortex shunt was developed using braided nitinol \u201cumbrella\u2010type\u201d ends with a kink\u2010resistant stem incorporating an internal one\u2010way valve. The peak force required to dislodge the Vortex shunt was significantly higher than commercially available shunts (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). Shunt deployment in the bench\u2010top model was easily confirmed with ultrasound guidance and the brisk decompression of the inflated porcine bladder thereafter. In\u2010vitro valve gauge pressure testing mirrored bladder pressures in human LUTO cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In\u2010vitro testing shows that the Vortex shunt may improve deployment, sonographic visualization, kink resistance, and dynamic size adjustment. Validation in preclinical animal models are warranted and currently underway.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6096","type":"journal-article","created":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T06:09:37Z","timestamp":1642658977000},"page":"164-171","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Development and in\u2010vitro characterization of a novel fetal vesicoamniotic shunt \u2013 The Vortex shunt"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0055-8894","authenticated-orcid":false,"given":"Kunj R.","family":"Sheth","sequence":"first","affiliation":[{"name":"Department of Urology, Division of Pediatric Urology at Stanford University School of Medicine Stanford University School of Medicine and Lucile Packard Children\u2019s Hospital  Stanford California USA"},{"name":"Department of Bioengineering Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Danzer","sequence":"additional","affiliation":[{"name":"Division on Pediatric Surgery, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Bioengineering Stanford University  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James K.","family":"Wall","sequence":"additional","affiliation":[{"name":"Department of Bioengineering Stanford University  Stanford California USA"},{"name":"Department of Surgery Division of Pediatric Surgery at Stanford University School of Medicine Stanford University School of Medicine and Lucile Packard Children\u2019s Hospital  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yair J.","family":"Blumenfeld","sequence":"additional","affiliation":[{"name":"Department of Obstetrics\u00a0&amp; Gynecology Division of Maternal\u2010Fetal Medicine and Obstetrics at Stanford University School of Medicine Stanford University School of Medicine and Lucile Packard Children\u2019s Hospital  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,1,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03476.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1074"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2020.105189"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000171117.38929.eb"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1878"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2009.03.010"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15844"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198607313150532"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60992-7"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15988"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2009.06.001"},{"issue":"1","key":"e_1_2_8_13_1","first-page":"52","article-title":"Modification of an intrauterine shunt catether to reduce the incidence of spontaneous displacement","volume":"84","author":"Richards DS","year":"1994","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340500449923"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767050903443491"},{"key":"e_1_2_8_16_1","volume-title":"Pediatric Urology Fall Congress Sept 26\u2010 322 29, 2019, Arizona","author":"Kurtz MP","year":"2019"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-020-05598-z"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000478011"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4850"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19074"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1159\/000515849"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2006.08.012"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2008.08.058"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.09.030"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2015.08.029"}],"container-title":["Prenatal Diagnosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.6096","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pd.6096","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.6096","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T03:21:53Z","timestamp":1693106513000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/pd.6096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,27]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1002\/pd.6096"],"URL":"https:\/\/doi.org\/10.1002\/pd.6096","archive":["Portico"],"relation":{},"ISSN":["0197-3851","1097-0223"],"issn-type":[{"value":"0197-3851","type":"print"},{"value":"1097-0223","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,27]]},"assertion":[{"value":"2021-09-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}