Radiofrequency ablation for TRAP sequence

Abstract

The natural history for twin reversed arterial perfusion (TRAP) sequence is greater than 50% mortality. A variety of strategies have been used for this relatively rare anomaly that have all been directed at stopping flow to the acardiac/acephalic mass. These strategies have included excision of the acardiac acephalic mass, fetoscopic laser cord coagulation, bipolar coagulation with either fetoscopic or ultrasound guidance, and suture ligation. Our group has developed the technique of ultrasound-guided radiofrequency ablation of the cord of the acephalic/acardiac mass.