OP10.09: Assessment of the Diastolic function in TTTS before and after Laser therapy based on ductus venosus waveform analysis

Abstract

Objectives: To evaluate early changes in foetal cardiac function in twin to twin transfusion syndrome (TTTS) using myocardial performance index pre and post laser therapy. Methods: Both donors and recipients of 51 monochorionic twin pregnancies complicated by TTTS were studied prospectively before and after laser therapy. The myocardial performance index (MPI) of both ventricles was calculated before (±24 hours) and after laser therapy (±24 hours) for the evaluation of early changes in the cardiac function. Results: As expected before laser, the donors had a significantly lower MPI-RV and MPI-LV (myocardial performance index in the right ventricle and in the left ventricle) (0.41 vs 0.67; P < 0.000000) and (0.36 vs 0.54; P < 0.0001) respectively. After laser therapy MPI increased in both the recipient and the donor in both ventricles: MPI-RV (0.67 vs 0.49; P < 0.02) (0.41 vs 0.19; P < 0.001), MPILV (0.54 vs 0.16; P < 0.02) (0.36 vs 0.29; P < 0.002). Diastolic time in the mitral valve of the recipient increased significantly. Conclusions: MPI appears is a sensitive index to evaluate early changes in the global cardiac function.