{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T20:09:17Z","timestamp":1767902957392,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,10,19]],"date-time":"2016-10-19T00:00:00Z","timestamp":1476835200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Twin\u2013twin transfusion syndrome (<jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content>) is the major cause for fetal demise in monochorionic diamniotic pregnancies. Estimated combined cardiac output (<jats:styled-content style=\"fixed-case\">CCO<\/jats:styled-content>) has not been studied in this setting. The primary aims of this study were to compare <jats:styled-content style=\"fixed-case\">CCO<\/jats:styled-content> in twin donor and recipient fetuses and assess differences in <jats:styled-content style=\"fixed-case\">CCO<\/jats:styled-content> before and after laser coagulation therapy. A secondary aim was to evaluate the relationship of <jats:styled-content style=\"fixed-case\">CCO<\/jats:styled-content> with perinatal mortality, defined as intrauterine or neonatal mortality (\u226430\u00a0days of age) in fetuses that underwent laser coagulation therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective review of fetuses with <jats:styled-content style=\"fixed-case\">TTTS<\/jats:styled-content> who received echocardiograms prior to laser therapy. Prelaser echocardiograms were performed in 66 fetuses, of which 45 (21 donor and 24 recipient) survived to the postlaser echocardiogram.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Donor <jats:styled-content style=\"fixed-case\">CCO<\/jats:styled-content> increased from a mean of 487\u00b1137\u00a0mL\/min\/kg prelaser to 592\u00b1128\u00a0mL\/min\/kg postlaser (<jats:italic>P<\/jats:italic>=.025). There was no significant change in mean recipient <jats:styled-content style=\"fixed-case\">CCO<\/jats:styled-content> from prelaser 551\u00b1165\u00a0mL\/min\/kg to postlaser 575\u00b1112\u00a0mL\/min\/kg (<jats:italic>P<\/jats:italic>=.564). In recipient fetuses, higher prelaser <jats:styled-content style=\"fixed-case\">CCO<\/jats:styled-content> correlated with increasing Quintero stage (<jats:italic>P<\/jats:italic>=.010) and perinatal mortality (<jats:italic>P<\/jats:italic>=.003). Thirty\u2010day postnatal outcome data were available for 38 fetuses, of whom 34 (89%) survived. Amongst survivors, 25 (74%) experienced an increase in <jats:styled-content style=\"fixed-case\">CCO<\/jats:styled-content>, while 9 (26%) experienced a decrease in <jats:styled-content style=\"fixed-case\">CCO<\/jats:styled-content> (<jats:italic>P<\/jats:italic>=.010). Donor fetuses had higher <jats:styled-content style=\"fixed-case\">CCO<\/jats:styled-content> after laser therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Higher prelaser <jats:styled-content style=\"fixed-case\">CCO<\/jats:styled-content> in recipient fetuses may indicate more advanced disease. Fetuses who exhibit a decrease in <jats:styled-content style=\"fixed-case\">CCO<\/jats:styled-content> after therapy laser may be at higher risk for perinatal mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13304","type":"journal-article","created":{"date-parts":[[2016,10,19]],"date-time":"2016-10-19T11:09:29Z","timestamp":1476875369000},"page":"1563-1570","source":"Crossref","is-referenced-by-count":7,"title":["Estimated combined cardiac output and laser therapy for twin\u2013twin transfusion syndrome"],"prefix":"10.1111","volume":"33","author":[{"given":"Shiraz A.","family":"Maskatia","sequence":"first","affiliation":[{"name":"Texas Children's Fetal Center Texas Children's Hospital  Houston Texas"},{"name":"Section of Pediatric Cardiology Texas Children's Hospital Baylor College of Medicine  Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Ruano","sequence":"additional","affiliation":[{"name":"Texas Children's Fetal Center Texas Children's Hospital  Houston Texas"},{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine  Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alireza A.","family":"Shamshirsaz","sequence":"additional","affiliation":[{"name":"Texas Children's Fetal Center Texas Children's Hospital  Houston Texas"},{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine  Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pouya","family":"Javadian","sequence":"additional","affiliation":[{"name":"Texas Children's Fetal Center Texas Children's Hospital  Houston Texas"},{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine  Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua A.","family":"Kailin","sequence":"additional","affiliation":[{"name":"Texas Children's Fetal Center Texas Children's Hospital  Houston Texas"},{"name":"Section of Pediatric Cardiology Texas Children's Hospital Baylor College of Medicine  Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Belfort","sequence":"additional","affiliation":[{"name":"Texas Children's Fetal Center Texas Children's Hospital  Houston Texas"},{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine  Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn A.","family":"Altman","sequence":"additional","affiliation":[{"name":"Texas Children's Fetal Center Texas Children's Hospital  Houston Texas"},{"name":"Section of Pediatric Cardiology Texas Children's Hospital Baylor College of Medicine  Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy A.","family":"Ayres","sequence":"additional","affiliation":[{"name":"Texas Children's Fetal Center Texas Children's Hospital  Houston Texas"},{"name":"Section of Pediatric Cardiology Texas Children's Hospital Baylor College of Medicine  Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,10,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.03.050"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/15.9.2008"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032597"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe048047"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.06.055"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.05.004"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7713"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4059"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10117"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.08.013"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7725"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.12.1662"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(85)80127-3"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12309"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200292"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2004.04.011"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.150.2.6691115"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(85)90348-5"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7488"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.06.045"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.09.015"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13442"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1264"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12215"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.12.003"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6230"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1203\/01.PDR.0000180558.03164.E8"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.06.018"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4015"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02680.x"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fecho.13304","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fecho.13304","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.13304","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T12:47:01Z","timestamp":1695559621000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.13304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10]]},"references-count":30,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2016,10]]}},"alternative-id":["10.1111\/echo.13304"],"URL":"https:\/\/doi.org\/10.1111\/echo.13304","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10]]}}}