{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:15:15Z","timestamp":1759968915325,"version":"build-2065373602"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T00:00:00Z","timestamp":1745625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Cardiovascular disturbances are common in twin\u2010twin transfusion syndrome (TTTS). However, the rate of improvement in cardiovascular burden in response to selective fetoscopic laser photocoagulation (SFLP) is not well known.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Fetal echocardiograms were performed prior to and 1\u00a0week following SFLP. Cardiovascular burden was characterized using the Children's Hospital of Philadelphia (CHOP) TTTS Cardiovascular (CV) Score. Pulsatility indices (PI) of the umbilical artery (UA) and middle cerebral artery (MCA), cerebroplacental ratio (CPR) and elements of CHOP CV Score were analyzed pre and post SFLP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>SFLP was performed in 198 subjects; 17 were excluded due demise post SFLP. Following SFLP, recipient (R) demonstrated an increase in MCA PI and a decrease in UA PI, with an increase in CPR. Donor (D) demonstrated a similar magnitude decrease in MCA PI and UA PI, yielding no change in CPR. Following SFLP, the mean CHOP CV Score decreased. The magnitude of change was greater in the subgroup with greater pre\u2010SFLP cardiovascular burden (CHOP CV Score \u2265 6).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Improvement in CV burden is seen as early as 1\u2010week post\u2010SFLP, supporting acute alteration of loading conditions as a significant contributor. Further study of the trajectory of CV alterations may provide insight into the complex mechanisms underlying TTTS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6805","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T11:13:53Z","timestamp":1745666033000},"page":"787-794","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Selective Fetoscopic Laser Photocoagulation of Placental Anastomoses Leads to Early Reduction of Cardiovascular Burden in the Twin\u2010Twin Transfusion Syndrome"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2913-3250","authenticated-orcid":false,"given":"Kasey J.","family":"Chaszczewski","sequence":"first","affiliation":[{"name":"Herma Heart Institute Children's Wisconsin  Milwaukee Wisconsin USA"},{"name":"Department of Pediatrics Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Perelman","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine B.","family":"Falkensammer","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Fetal Heart Program at the Cardiac Center at The Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"The Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment The Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Szwast","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Fetal Heart Program at the Cardiac Center at The Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"The Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment The Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengcheng","family":"Pang","sequence":"additional","affiliation":[{"name":"Guangdong General Hospital and Guangdong Cardiovascular Institute  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiyun","family":"Tian","sequence":"additional","affiliation":[{"name":"Fetal Heart Program at the Cardiac Center at The Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5829-1961","authenticated-orcid":false,"given":"Juliana","family":"Gebb","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"The Richard D. 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