{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T11:41:56Z","timestamp":1775734916928,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,6,6]],"date-time":"2013-06-06T00:00:00Z","timestamp":1370476800000},"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":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p><jats:italic>Cardiac dysfunction is common in the recipient fetus of twin\u2013twin transfusion syndrome (<jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content>). In this study, we aimed to document the severity of fetal cardiac dysfunction in Stage <jats:styled-content style=\"fixed-case\">IV TTTS<\/jats:styled-content> (fetal hydrops) and assess evolution of cardiac function longitudinally after fetoscopic laser surgery<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:italic>We reviewed obstetric ultrasound examination data, pre\u2010 and postoperative echocardiograms and neonatal outcomes for 22 cases of Stage <jats:styled-content style=\"fixed-case\">IV TTTS<\/jats:styled-content> undergoing fetoscopic laser ablation of placental anastomoses between 1998 and 2011. Myocardial performance index, atrioventricular valve flow patterns, ventricular shortening fraction, ventricular hypertrophy, outflow tract obstruction and venous Doppler waveforms were assessed<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>Nineteen fetuses (86.4%) had ascites, eight (36.4%) had pleural effusions, nine (40.9%) had a pericardial effusion and 12 (54.5%) had subcutaneous edema at presentation. Preoperatively, cardiac function was grossly abnormal in all. Eight fetuses (36.4%) had functional pulmonary atresia and one (4.5%) had functional aortic atresia. Seventy\u2010seven percent of recipient fetuses survived until birth. Postoperative echocardiographic follow\u2010up (mean, 26 days) showed that indices of fetal cardiac function improved considerably, but never completely normalized. Six of the eight fetuses with functional pulmonary atresia (75.0%), as well as the fetus with functional aortic atresia, survived to birth. In all cases, the functional atresia resolved within 48 h of laser ablation therapy and none had structural valve anomalies at birth. All fetal effusions resolved after the laser<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic>Fetoscopic laser ablation of placental anastomoses reverses cardiac dysfunction and valvulopathy, even in the most severe cases of <jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content>. However, recovery takes longer than in early stage disease. Copyright \u00a9 2013 ISUOG. Published by John Wiley &amp; Sons Ltd<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.12454","type":"journal-article","created":{"date-parts":[[2013,3,13]],"date-time":"2013-03-13T19:42:57Z","timestamp":1363203777000},"page":"64-69","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Fetal cardiac function in recipient twins undergoing fetoscopic laser ablation of placental anastomoses for Stage <scp>IV<\/scp> twin\u2013twin transfusion syndrome"],"prefix":"10.1002","volume":"42","author":[{"given":"T.","family":"Van Mieghem","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. M.","family":"Martin","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Weber","sequence":"additional","affiliation":[{"name":"Fetal Cardiac Program, Hospital for Sick Children University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Barrea","sequence":"additional","affiliation":[{"name":"Fetal Cardiac Program, Hospital for Sick Children University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Windrim","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. K.","family":"Hornberger","sequence":"additional","affiliation":[{"name":"Fetal Cardiac Program, Hospital for Sick Children University of Toronto  Toronto Ontario Canada"},{"name":"Fetal &amp; Neonatal Cardiology Program, Pediatric Cardiology, 4C2 Stollery Children's Hospital University of Edmonton  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Jaeggi","sequence":"additional","affiliation":[{"name":"Fetal Cardiac Program, Hospital for Sick Children University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,6,6]]},"reference":[{"issue":"514","key":"e_1_2_5_2_1","first-page":"e1","volume":"199","author":"Lewi L","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/15.9.2008"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2009.02.005"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5211"},{"issue":"392","key":"e_1_2_5_6_1","first-page":"e1","volume":"197","author":"Tian Z","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_5_7_1","volume":"2010","author":"Lewi L","year":"2010","journal-title":"Int J Pediatr"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032597"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2010.29.10.1431"},{"issue":"400","key":"e_1_2_5_10_1","first-page":"e1","article-title":"Assessment of fetal cardiac function before and after therapy for\u2009twin\u2010to\u2010twin\u2009transfusion syndrome","volume":"200","author":"Van Mieghem T","year":"2009","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2007.26.11.1491"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2004.057497"},{"issue":"393","key":"e_1_2_5_13_1","first-page":"e1","volume":"204","author":"Kontopoulos EV","year":"2011","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200292"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2012.01489.x"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.256"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1996"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.09.120"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.03.042"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2007.00070.x"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2818"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.2008.01425.x"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7748"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/heart.88.3.271"},{"issue":"444","key":"e_1_2_5_25_1","volume":"203","author":"Salomon LJ","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318195873e"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.12454","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.12454","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T21:12:01Z","timestamp":1696367521000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.12454"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,6]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,7]]}},"alternative-id":["10.1002\/uog.12454"],"URL":"https:\/\/doi.org\/10.1002\/uog.12454","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6,6]]},"assertion":[{"value":"2012-12-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-06-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}