Tracheal side effects following fetal endoscopic tracheal occlusion for severe congenital diaphragmatic hernia
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Despite optimal neonatal care and even in large referral centres, between 20% and 30% of neonates with isolated congenital diaphragmatic hernia (CDH) will not survive . The leading causes of death remain in essence pulmonary hypoplasia and persistent pulmonary hypertension (PPHT). Prenatal medical imaging methods are used to predict individual outcome, which provides parents with prenatal options. For those with a predicted poor outcome this might include prenatal intervention, which aims to improve lung development rather than repairing the anatomical defect. Early attempts by prenatal surgical repair of the defect were abandoned as they required access by hysterotomy and because reducing liver herniation compromises the fetal circulation . Tracheal occlusion (TO) prevents egress of lung liquid produced by the airway epithelium, hence induces tissue stretch, which acts as a signal for lung growth [3, 4]. Clinically TO was initially performed using extra-luminal clips with...
KeywordsCongenital Diaphragmatic Hernia Congenital Diaphragmatic Hernia Lung Growth Tracheal Occlusion Balloon Removal
The FETO programme is in part supported by the European Commission (EuroSTEC, 6th Framework, LSHC-CT-2006-037409) and the Flemish Community of Belgium (IWT/ 070715). JDP is a “clinical researcher” of the Fonds voor Wetenschappelijk Onderzoek Vlaanderen (1.8.012.07.N.02). AD is a clinical researcher supported by the KOOR funds of the University Hospitals Leuven.
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