Live born recipient of twin–twin transfusion syndrome with anomalous mitral arcade. Issue 5 (29th May 2019)

• Record Type: Journal Article
• Authors: Ødegård, Siv Steinsmo; Kahrs, Birgitte; Lang, Astri Maria; Nyrnes, Siri Ann
• Is Part Of: BMJ case reports. Volume 12:Issue 5(2019)
• Publication Date: 2019-05-29
• Subjects: heart failure -- valvar diseases -- neonatal intensive care -- obstetrics and gynaecology -- ultrasonography; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-229237
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : We present a case report of anomalous mitral arcade in a live born former recipient of twin–twin transfusion syndrome. At 33+0 week of gestation fetal ultrasound demonstrated that she had a large mitral insufficiency, decreased movement of the lateral cusp of the mitral valve and dilated left atrium. The twins were delivered by caesarean section at week 33+1 due to fetal distress. The former recipient twin developed decompensated heart failure during her first day of life and was transferred to a surgical paediatric heart centre. Her clinical condition rapidly deteriorated, and she died of congestive heart failure 3 days old. Prenatal signs of anomalous mitral arcade in a recipient of twin–twin transfusion syndrome should warrant preparation of a critically ill neonate, including parental counselling and in utero transfer to surgical paediatric heart centre. There is a surgical treatment option available for neonates, but the experience with this technique is still very limited with a high risk of morbidity and mortality.