Fetal laser ablation of feeding artery of cystic lung lesions with systemic arterial blood supply
ABSTRACT Objective To assess the effectiveness of laser surgery in fetuses with a cystic lung lesion with systemic arterial blood supply (hybrid lung lesion) at risk of perinatal death. Methods A cohort of five consecutive fetuses with a large hybrid lung lesion associated with hydrops and/or pleura...
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| Veröffentlicht in: | Ultrasound in obstetrics & gynecology 2017-06, Vol.49 (6), p.744-750 |
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| creator | Cruz‐Martinez, R. Martínez‐Rodríguez, M. Bermúdez‐Rojas, M. Magaña‐Abarca, C. Narvaez‐Dominguez, V. Rojas‐Macedo, A. Bautista‐García, N. Alcocer‐Alcocer, M. |
| description | ABSTRACT
Objective
To assess the effectiveness of laser surgery in fetuses with a cystic lung lesion with systemic arterial blood supply (hybrid lung lesion) at risk of perinatal death.
Methods
A cohort of five consecutive fetuses with a large hybrid lung lesion associated with hydrops and/or pleural effusion with severe lung compression was selected for percutaneous ultrasound‐guided fetal laser ablation of the feeding artery (FLAFA) before 32 weeks' gestation in a single tertiary national referral center in Queretaro, Mexico. The primary outcomes were survival and need for postnatal surgery.
Results
FLAFA was performed successfully in all cases at a median gestational age of 24.9 (range, 24.4–31.7) weeks. After fetal intervention, dimensions in both lungs increased and fluid effusions resolved in all cases. All cases were delivered liveborn at term at a median gestational age of 39.6 (range, 38.0–39.7) weeks, without respiratory morbidity or need for oxygen support, resulting in perinatal survival of 100%. During follow‐up, three (60%) cases showed progressive regression of the entire lung mass and did not require postnatal surgery, whereas in two (40%) cases a progressive decrease in size of the mass was observed but a cystic portion of the lung mass persisted and postnatal lobectomy was required.
Conclusion
In fetuses with large hybrid lung lesions at risk of perinatal death, FLAFA is feasible and could improve survival and decrease the need for postnatal surgery. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. |
| doi_str_mv | 10.1002/uog.16011 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1826707598</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1904666006</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3881-3724169c363b444dc6bd26d01847cb46929c1037fb690f8a47844c58cba2a7233</originalsourceid><addsrcrecordid>eNp1kEFLwzAUgIMobk4P_gEJeNFD3UuaJelRhpuC4MWdQ5qmsyNbZtIy-u-N2_QgeAq89_Hx8iF0TeCBANBx55cPhAMhJ2hIGC8yEDA5RUMoOGSCF3SALmJcAQBnOT9HAypynssJGyI9s6122OloA9al023jN9jXuLa2ajZLrENrQ_89MX1sG4Ndl6bOxsRFvGvaDxzTwq7Tas82SVc67yscu-3W9ZforNYu2qvjO0KL2dP79Dl7fZu_TB9fM5NLSbJcUEZ4YdJhJWOsMrysKK-ASCZMmT5FC0MgF3XJC6ilZkIyZibSlJpqQfN8hO4O3m3wn52NrVo30Vjn9Mb6LioiKRcgJoVM6O0fdOW7sEnXKVIA45ynUom6P1Am-BiDrdU2NGsdekVAfXdXqbvad0_szdHYlWtb_ZI_oRMwPgC7xtn-f5NavM0Pyi_naYt4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1904666006</pqid></control><display><type>article</type><title>Fetal laser ablation of feeding artery of cystic lung lesions with systemic arterial blood supply</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Access via Wiley Online Library</source><source>Wiley Online Library (Open Access Collection)</source><creator>Cruz‐Martinez, R. ; Martínez‐Rodríguez, M. ; Bermúdez‐Rojas, M. ; Magaña‐Abarca, C. ; Narvaez‐Dominguez, V. ; Rojas‐Macedo, A. ; Bautista‐García, N. ; Alcocer‐Alcocer, M.</creator><creatorcontrib>Cruz‐Martinez, R. ; Martínez‐Rodríguez, M. ; Bermúdez‐Rojas, M. ; Magaña‐Abarca, C. ; Narvaez‐Dominguez, V. ; Rojas‐Macedo, A. ; Bautista‐García, N. ; Alcocer‐Alcocer, M.</creatorcontrib><description>ABSTRACT
Objective
To assess the effectiveness of laser surgery in fetuses with a cystic lung lesion with systemic arterial blood supply (hybrid lung lesion) at risk of perinatal death.
Methods
A cohort of five consecutive fetuses with a large hybrid lung lesion associated with hydrops and/or pleural effusion with severe lung compression was selected for percutaneous ultrasound‐guided fetal laser ablation of the feeding artery (FLAFA) before 32 weeks' gestation in a single tertiary national referral center in Queretaro, Mexico. The primary outcomes were survival and need for postnatal surgery.
Results
FLAFA was performed successfully in all cases at a median gestational age of 24.9 (range, 24.4–31.7) weeks. After fetal intervention, dimensions in both lungs increased and fluid effusions resolved in all cases. All cases were delivered liveborn at term at a median gestational age of 39.6 (range, 38.0–39.7) weeks, without respiratory morbidity or need for oxygen support, resulting in perinatal survival of 100%. During follow‐up, three (60%) cases showed progressive regression of the entire lung mass and did not require postnatal surgery, whereas in two (40%) cases a progressive decrease in size of the mass was observed but a cystic portion of the lung mass persisted and postnatal lobectomy was required.
Conclusion
In fetuses with large hybrid lung lesions at risk of perinatal death, FLAFA is feasible and could improve survival and decrease the need for postnatal surgery. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.</description><identifier>ISSN: 0960-7692</identifier><identifier>EISSN: 1469-0705</identifier><identifier>DOI: 10.1002/uog.16011</identifier><identifier>PMID: 27363854</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Age ; Arteries - surgery ; Blood ; bronchopulmonary sequestration ; Cohort Studies ; Compressing ; Compression ; congenital cystic adenomatoid malformation ; Copyright ; Cystic Adenomatoid Malformation of Lung, Congenital - complications ; Cystic Adenomatoid Malformation of Lung, Congenital - diagnostic imaging ; Cystic Adenomatoid Malformation of Lung, Congenital - physiopathology ; Cystic Adenomatoid Malformation of Lung, Congenital - surgery ; Death ; Edema ; Feasibility ; Feeding ; Female ; Fetal Diseases - diagnostic imaging ; Fetal Diseases - physiopathology ; Fetal Diseases - surgery ; fetal surgery ; Fetal Therapies ; Fetuses ; Gestation ; Gestational Age ; Humans ; hybrid lung lesion ; Intervention ; Laser ablation ; Laser Therapy ; Lasers ; Lesions ; Lung Diseases - complications ; Lung Diseases - congenital ; Lung Diseases - diagnosis ; Lung Diseases - diagnostic imaging ; Lung Diseases - physiopathology ; Lung Diseases - surgery ; Lungs ; Mexico ; Morbidity ; Mortality ; Oxygen ; Pleural effusion ; Pregnancy ; Prospective Studies ; Regression ; Risk assessment ; Surgery ; Survival ; Treatment Outcome ; Ultrasonography, Interventional ; Ultrasonography, Prenatal ; Ultrasound</subject><ispartof>Ultrasound in obstetrics & gynecology, 2017-06, Vol.49 (6), p.744-750</ispartof><rights>Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3881-3724169c363b444dc6bd26d01847cb46929c1037fb690f8a47844c58cba2a7233</citedby><cites>FETCH-LOGICAL-c3881-3724169c363b444dc6bd26d01847cb46929c1037fb690f8a47844c58cba2a7233</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fuog.16011$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fuog.16011$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,1434,27929,27930,45579,45580,46414,46838</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27363854$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cruz‐Martinez, R.</creatorcontrib><creatorcontrib>Martínez‐Rodríguez, M.</creatorcontrib><creatorcontrib>Bermúdez‐Rojas, M.</creatorcontrib><creatorcontrib>Magaña‐Abarca, C.</creatorcontrib><creatorcontrib>Narvaez‐Dominguez, V.</creatorcontrib><creatorcontrib>Rojas‐Macedo, A.</creatorcontrib><creatorcontrib>Bautista‐García, N.</creatorcontrib><creatorcontrib>Alcocer‐Alcocer, M.</creatorcontrib><title>Fetal laser ablation of feeding artery of cystic lung lesions with systemic arterial blood supply</title><title>Ultrasound in obstetrics & gynecology</title><addtitle>Ultrasound Obstet Gynecol</addtitle><description>ABSTRACT
Objective
To assess the effectiveness of laser surgery in fetuses with a cystic lung lesion with systemic arterial blood supply (hybrid lung lesion) at risk of perinatal death.
Methods
A cohort of five consecutive fetuses with a large hybrid lung lesion associated with hydrops and/or pleural effusion with severe lung compression was selected for percutaneous ultrasound‐guided fetal laser ablation of the feeding artery (FLAFA) before 32 weeks' gestation in a single tertiary national referral center in Queretaro, Mexico. The primary outcomes were survival and need for postnatal surgery.
Results
FLAFA was performed successfully in all cases at a median gestational age of 24.9 (range, 24.4–31.7) weeks. After fetal intervention, dimensions in both lungs increased and fluid effusions resolved in all cases. All cases were delivered liveborn at term at a median gestational age of 39.6 (range, 38.0–39.7) weeks, without respiratory morbidity or need for oxygen support, resulting in perinatal survival of 100%. During follow‐up, three (60%) cases showed progressive regression of the entire lung mass and did not require postnatal surgery, whereas in two (40%) cases a progressive decrease in size of the mass was observed but a cystic portion of the lung mass persisted and postnatal lobectomy was required.
Conclusion
In fetuses with large hybrid lung lesions at risk of perinatal death, FLAFA is feasible and could improve survival and decrease the need for postnatal surgery. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.</description><subject>Age</subject><subject>Arteries - surgery</subject><subject>Blood</subject><subject>bronchopulmonary sequestration</subject><subject>Cohort Studies</subject><subject>Compressing</subject><subject>Compression</subject><subject>congenital cystic adenomatoid malformation</subject><subject>Copyright</subject><subject>Cystic Adenomatoid Malformation of Lung, Congenital - complications</subject><subject>Cystic Adenomatoid Malformation of Lung, Congenital - diagnostic imaging</subject><subject>Cystic Adenomatoid Malformation of Lung, Congenital - physiopathology</subject><subject>Cystic Adenomatoid Malformation of Lung, Congenital - surgery</subject><subject>Death</subject><subject>Edema</subject><subject>Feasibility</subject><subject>Feeding</subject><subject>Female</subject><subject>Fetal Diseases - diagnostic imaging</subject><subject>Fetal Diseases - physiopathology</subject><subject>Fetal Diseases - surgery</subject><subject>fetal surgery</subject><subject>Fetal Therapies</subject><subject>Fetuses</subject><subject>Gestation</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>hybrid lung lesion</subject><subject>Intervention</subject><subject>Laser ablation</subject><subject>Laser Therapy</subject><subject>Lasers</subject><subject>Lesions</subject><subject>Lung Diseases - complications</subject><subject>Lung Diseases - congenital</subject><subject>Lung Diseases - diagnosis</subject><subject>Lung Diseases - diagnostic imaging</subject><subject>Lung Diseases - physiopathology</subject><subject>Lung Diseases - surgery</subject><subject>Lungs</subject><subject>Mexico</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Oxygen</subject><subject>Pleural effusion</subject><subject>Pregnancy</subject><subject>Prospective Studies</subject><subject>Regression</subject><subject>Risk assessment</subject><subject>Surgery</subject><subject>Survival</subject><subject>Treatment Outcome</subject><subject>Ultrasonography, Interventional</subject><subject>Ultrasonography, Prenatal</subject><subject>Ultrasound</subject><issn>0960-7692</issn><issn>1469-0705</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEFLwzAUgIMobk4P_gEJeNFD3UuaJelRhpuC4MWdQ5qmsyNbZtIy-u-N2_QgeAq89_Hx8iF0TeCBANBx55cPhAMhJ2hIGC8yEDA5RUMoOGSCF3SALmJcAQBnOT9HAypynssJGyI9s6122OloA9al023jN9jXuLa2ajZLrENrQ_89MX1sG4Ndl6bOxsRFvGvaDxzTwq7Tas82SVc67yscu-3W9ZforNYu2qvjO0KL2dP79Dl7fZu_TB9fM5NLSbJcUEZ4YdJhJWOsMrysKK-ASCZMmT5FC0MgF3XJC6ilZkIyZibSlJpqQfN8hO4O3m3wn52NrVo30Vjn9Mb6LioiKRcgJoVM6O0fdOW7sEnXKVIA45ynUom6P1Am-BiDrdU2NGsdekVAfXdXqbvad0_szdHYlWtb_ZI_oRMwPgC7xtn-f5NavM0Pyi_naYt4</recordid><startdate>201706</startdate><enddate>201706</enddate><creator>Cruz‐Martinez, R.</creator><creator>Martínez‐Rodríguez, M.</creator><creator>Bermúdez‐Rojas, M.</creator><creator>Magaña‐Abarca, C.</creator><creator>Narvaez‐Dominguez, V.</creator><creator>Rojas‐Macedo, A.</creator><creator>Bautista‐García, N.</creator><creator>Alcocer‐Alcocer, M.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201706</creationdate><title>Fetal laser ablation of feeding artery of cystic lung lesions with systemic arterial blood supply</title><author>Cruz‐Martinez, R. ; Martínez‐Rodríguez, M. ; Bermúdez‐Rojas, M. ; Magaña‐Abarca, C. ; Narvaez‐Dominguez, V. ; Rojas‐Macedo, A. ; Bautista‐García, N. ; Alcocer‐Alcocer, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3881-3724169c363b444dc6bd26d01847cb46929c1037fb690f8a47844c58cba2a7233</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age</topic><topic>Arteries - surgery</topic><topic>Blood</topic><topic>bronchopulmonary sequestration</topic><topic>Cohort Studies</topic><topic>Compressing</topic><topic>Compression</topic><topic>congenital cystic adenomatoid malformation</topic><topic>Copyright</topic><topic>Cystic Adenomatoid Malformation of Lung, Congenital - complications</topic><topic>Cystic Adenomatoid Malformation of Lung, Congenital - diagnostic imaging</topic><topic>Cystic Adenomatoid Malformation of Lung, Congenital - physiopathology</topic><topic>Cystic Adenomatoid Malformation of Lung, Congenital - surgery</topic><topic>Death</topic><topic>Edema</topic><topic>Feasibility</topic><topic>Feeding</topic><topic>Female</topic><topic>Fetal Diseases - diagnostic imaging</topic><topic>Fetal Diseases - physiopathology</topic><topic>Fetal Diseases - surgery</topic><topic>fetal surgery</topic><topic>Fetal Therapies</topic><topic>Fetuses</topic><topic>Gestation</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>hybrid lung lesion</topic><topic>Intervention</topic><topic>Laser ablation</topic><topic>Laser Therapy</topic><topic>Lasers</topic><topic>Lesions</topic><topic>Lung Diseases - complications</topic><topic>Lung Diseases - congenital</topic><topic>Lung Diseases - diagnosis</topic><topic>Lung Diseases - diagnostic imaging</topic><topic>Lung Diseases - physiopathology</topic><topic>Lung Diseases - surgery</topic><topic>Lungs</topic><topic>Mexico</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Oxygen</topic><topic>Pleural effusion</topic><topic>Pregnancy</topic><topic>Prospective Studies</topic><topic>Regression</topic><topic>Risk assessment</topic><topic>Surgery</topic><topic>Survival</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Interventional</topic><topic>Ultrasonography, Prenatal</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cruz‐Martinez, R.</creatorcontrib><creatorcontrib>Martínez‐Rodríguez, M.</creatorcontrib><creatorcontrib>Bermúdez‐Rojas, M.</creatorcontrib><creatorcontrib>Magaña‐Abarca, C.</creatorcontrib><creatorcontrib>Narvaez‐Dominguez, V.</creatorcontrib><creatorcontrib>Rojas‐Macedo, A.</creatorcontrib><creatorcontrib>Bautista‐García, N.</creatorcontrib><creatorcontrib>Alcocer‐Alcocer, M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Ultrasound in obstetrics & gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cruz‐Martinez, R.</au><au>Martínez‐Rodríguez, M.</au><au>Bermúdez‐Rojas, M.</au><au>Magaña‐Abarca, C.</au><au>Narvaez‐Dominguez, V.</au><au>Rojas‐Macedo, A.</au><au>Bautista‐García, N.</au><au>Alcocer‐Alcocer, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fetal laser ablation of feeding artery of cystic lung lesions with systemic arterial blood supply</atitle><jtitle>Ultrasound in obstetrics & gynecology</jtitle><addtitle>Ultrasound Obstet Gynecol</addtitle><date>2017-06</date><risdate>2017</risdate><volume>49</volume><issue>6</issue><spage>744</spage><epage>750</epage><pages>744-750</pages><issn>0960-7692</issn><eissn>1469-0705</eissn><abstract>ABSTRACT
Objective
To assess the effectiveness of laser surgery in fetuses with a cystic lung lesion with systemic arterial blood supply (hybrid lung lesion) at risk of perinatal death.
Methods
A cohort of five consecutive fetuses with a large hybrid lung lesion associated with hydrops and/or pleural effusion with severe lung compression was selected for percutaneous ultrasound‐guided fetal laser ablation of the feeding artery (FLAFA) before 32 weeks' gestation in a single tertiary national referral center in Queretaro, Mexico. The primary outcomes were survival and need for postnatal surgery.
Results
FLAFA was performed successfully in all cases at a median gestational age of 24.9 (range, 24.4–31.7) weeks. After fetal intervention, dimensions in both lungs increased and fluid effusions resolved in all cases. All cases were delivered liveborn at term at a median gestational age of 39.6 (range, 38.0–39.7) weeks, without respiratory morbidity or need for oxygen support, resulting in perinatal survival of 100%. During follow‐up, three (60%) cases showed progressive regression of the entire lung mass and did not require postnatal surgery, whereas in two (40%) cases a progressive decrease in size of the mass was observed but a cystic portion of the lung mass persisted and postnatal lobectomy was required.
Conclusion
In fetuses with large hybrid lung lesions at risk of perinatal death, FLAFA is feasible and could improve survival and decrease the need for postnatal surgery. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>27363854</pmid><doi>10.1002/uog.16011</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Ultrasound in obstetrics & gynecology, 2017-06, Vol.49 (6), p.744-750 |
| issn | 0960-7692 1469-0705 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via Wiley Online Library; Wiley Online Library (Open Access Collection) |
| subjects | Age Arteries - surgery Blood bronchopulmonary sequestration Cohort Studies Compressing Compression congenital cystic adenomatoid malformation Copyright Cystic Adenomatoid Malformation of Lung, Congenital - complications Cystic Adenomatoid Malformation of Lung, Congenital - diagnostic imaging Cystic Adenomatoid Malformation of Lung, Congenital - physiopathology Cystic Adenomatoid Malformation of Lung, Congenital - surgery Death Edema Feasibility Feeding Female Fetal Diseases - diagnostic imaging Fetal Diseases - physiopathology Fetal Diseases - surgery fetal surgery Fetal Therapies Fetuses Gestation Gestational Age Humans hybrid lung lesion Intervention Laser ablation Laser Therapy Lasers Lesions Lung Diseases - complications Lung Diseases - congenital Lung Diseases - diagnosis Lung Diseases - diagnostic imaging Lung Diseases - physiopathology Lung Diseases - surgery Lungs Mexico Morbidity Mortality Oxygen Pleural effusion Pregnancy Prospective Studies Regression Risk assessment Surgery Survival Treatment Outcome Ultrasonography, Interventional Ultrasonography, Prenatal Ultrasound |
| title | Fetal laser ablation of feeding artery of cystic lung lesions with systemic arterial blood supply |
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