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[Twin-twin transfusion syndrome: report of two cases with hemodynamic complications]
R Mareschal-Desandes1, J M Hascoët, G Bosser
1Service de néonatologie-soins intensifs et réanimation néonatals-génétique, maternité régionale, 54042 Nancy, France.
Case Reports:
We report two cases of cardiac dysfunction in twin-twin transfusion syndrome (TTTS) evaluated with serial echocardiography. Two cases of TTTS were referred at 27 and 26 weeks. At delivery at 31 weeks, the first recipient twin had evidence of severe cardiac dysfunction with decreased ventricular function and transient systemic hypertension. There was polycythaemia. Favorable outcome was observed after treatment with arterial vasodilating (nicardipine) and inotropic agents (dobutamine, enoximone), and reduction of haematocrit. At 28 weeks the other recipient twin had cardiac dilatation with hypokinetic myocardium. These alterations were cured by dobutamine.
Conclusion:
These cases show that even severe cardiac dysfunction may be reversed after birth unlike in utero natural evolution.