Percutaneous fetoscopic laser decompression of congenital high airway obstruction syndrome (CHAOS) from laryngeal atresia via a single trocar--current technical constraints and potential solutions for future interventions

Thomas Kohl, Patricia van de Vondel, Rüdiger Stressig, Hans C. Wartenberg, Axel Heep, Sabine Keiner, Andreas Müller, Axel Franz, Susanne Fröhlich, Winfried Willinek, Ulrich Gembruch

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Abstract

OBJECTIVE: To alleviate congenital high airway obstruction syndrome (CHAOS) from laryngeal atresia by percutaneous minimally-invasive fetoscopic tracheal decompression using laser. METHODS: The procedure was performed via one trocar under general maternofetal anesthesia in a human fetus with CHAOS from laryngeal atresia at 21+6 weeks of gestation. RESULTS: Normalization of the lung-heart size relationship was observed within days after the procedure. The fetus was delivered by ex utero intrapartum treatment (EXIT) in order to perform a tracheotomy at 31+1 weeks of gestation and survived hospital treatment to discharge. CONCLUSIONS: Percutaneous minimally-invasive fetoscopic decompression of the fetal trachea via a single trocar is feasible in human fetuses with CHAOS from laryngeal atresia
Original languageEnglish
Pages (from-to)67-71
JournalFetal Diagnosis and Therapy
Volume25
Issue number1
DOIs
Publication statusPublished - 2009

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