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

Fetal Diagn Ther. 2009;25(1):67-71. doi: 10.1159/000200017. Epub 2009 Feb 6.

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.

Publication types

  • Case Reports
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Airway Obstruction / congenital
  • Airway Obstruction / diagnostic imaging
  • Airway Obstruction / etiology
  • Airway Obstruction / surgery*
  • Decompression, Surgical / methods
  • Female
  • Fetal Diseases / etiology
  • Fetal Diseases / surgery*
  • Fetoscopy / methods
  • Fetus / surgery
  • Humans
  • Laryngeal Diseases / complications*
  • Laryngeal Diseases / surgery
  • Laser Therapy / instrumentation
  • Laser Therapy / methods*
  • Pregnancy
  • Surgical Instruments
  • Syndrome
  • Trachea / diagnostic imaging
  • Trachea / surgery*
  • Ultrasonography, Prenatal