Annals of Pediatric Cardiology
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CASE REPORT
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Modified underlying cardiac disease severity in twin-twin transfusion syndrome


1 Department of Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
2 Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
3 Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan
4 Departement of Pediatrics, Kitasato University, Kanagawa, Japan
5 Department of Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Saitama; Departement of Pediatrics, Kitasato University, Kanagawa, Japan

Correspondence Address:
Hideaki Senzaki,
IPE Building 415, Department of Pediatric Cardiology, Kitasato University, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa 252-0374
Japan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/apc.APC_112_18

Twin-twin transfusion syndrome or related conditions affect fetal loading. We report monochorionic-diamniotic twins. Twin 1 had Ebstein anomaly with mild tricuspid regurgitation (TR) and slightly thickened tricuspid valve leaflets with plastering. Twin 2 had tricuspid valve dysplasia (with abnormal thickening but without plastering) with moderate TR and mild right atrial dilatation. After birth, the severity of TR was greatly reduced in the recipient but increased in the donor. Therefore, intravascular volume change which was due to twin-twin transfusion syndrome seemed to affect the severity of the valvar disease in fetuses. This case suggests that the intrinsic severity of fetal tricuspid valvular disease may be overestimated in the recipient and underestimated in the donor twin. These factors need to be taken into consideration in clinical decision-making.


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