Abstract
Purpose: Temporary tracheal occlusion is an effective strategy to enlarge fetal lungs, but the optimal technique to accomplish occlusion is unknown. External clips are effective when applied fetoscopically (Fetendo clip), but require a difficult fetal neck dissection. This study was undertaken to assess the feasibility of intratracheal balloon occlusion, revisiting the internal occlusion strategy. Methods: (1) The internal diameter (ID) of human fetal trachea (53 fetuses; 14 to 41 weeks' gestation) was compared using a computer-assisted image analyzer and sonography, ex vivo. (2) Volume to diameter relationship of the balloon (balloon configuration curve) was defined using an image analyzing computer. (3) Using the trachea of fetal sheep, pressures that break balloon tracheal seal (seal pressure) were investigated. Results: (1) Between 16 and 41 weeks' gestation, tracheal ID (range, 0.7 to 5.4 mm) correlates significantly with gestational age. (2) Balloon volume required to achieve tracheal seal could be determined based on the tracheal growth curve and the balloon configuration curve. (3) Tracheal seal breaking points varied depending on the tracheal specimen tested. Conclusion: Internal tracheal occlusion using a balloon is feasible with minimal tracheal damage if the balloon volume is adjusted to fetal tracheal growth. Copyright (C) 2000 by W.B. Saunders Company.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1566-1570 |
| Number of pages | 5 |
| Journal | Journal of Pediatric Surgery |
| Volume | 35 |
| Issue number | 11 |
| DOIs | |
| State | Published - 2000 |
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Keywords
- Congenital diaphragmatic hernia
- Detachable silicone balloon
- Fetal trachea
- Fetendo clip
ASJC Scopus subject areas
- Surgery
Cite this
Balloon tracheal occlusion for congenital diaphragmatic hernia : Experimental studies. / Chiba, Toshio; Albanese, Craig T.; Farmer, Diana L; Dowd, Christopher F.; Filly, Roy A.; Machin, Geoffrey A.; Harrison, Michael R.
In: Journal of Pediatric Surgery, Vol. 35, No. 11, 2000, p. 1566-1570.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Balloon tracheal occlusion for congenital diaphragmatic hernia
T2 - Experimental studies
AU - Chiba, Toshio
AU - Albanese, Craig T.
AU - Farmer, Diana L
AU - Dowd, Christopher F.
AU - Filly, Roy A.
AU - Machin, Geoffrey A.
AU - Harrison, Michael R.
PY - 2000
Y1 - 2000
N2 - Purpose: Temporary tracheal occlusion is an effective strategy to enlarge fetal lungs, but the optimal technique to accomplish occlusion is unknown. External clips are effective when applied fetoscopically (Fetendo clip), but require a difficult fetal neck dissection. This study was undertaken to assess the feasibility of intratracheal balloon occlusion, revisiting the internal occlusion strategy. Methods: (1) The internal diameter (ID) of human fetal trachea (53 fetuses; 14 to 41 weeks' gestation) was compared using a computer-assisted image analyzer and sonography, ex vivo. (2) Volume to diameter relationship of the balloon (balloon configuration curve) was defined using an image analyzing computer. (3) Using the trachea of fetal sheep, pressures that break balloon tracheal seal (seal pressure) were investigated. Results: (1) Between 16 and 41 weeks' gestation, tracheal ID (range, 0.7 to 5.4 mm) correlates significantly with gestational age. (2) Balloon volume required to achieve tracheal seal could be determined based on the tracheal growth curve and the balloon configuration curve. (3) Tracheal seal breaking points varied depending on the tracheal specimen tested. Conclusion: Internal tracheal occlusion using a balloon is feasible with minimal tracheal damage if the balloon volume is adjusted to fetal tracheal growth. Copyright (C) 2000 by W.B. Saunders Company.
AB - Purpose: Temporary tracheal occlusion is an effective strategy to enlarge fetal lungs, but the optimal technique to accomplish occlusion is unknown. External clips are effective when applied fetoscopically (Fetendo clip), but require a difficult fetal neck dissection. This study was undertaken to assess the feasibility of intratracheal balloon occlusion, revisiting the internal occlusion strategy. Methods: (1) The internal diameter (ID) of human fetal trachea (53 fetuses; 14 to 41 weeks' gestation) was compared using a computer-assisted image analyzer and sonography, ex vivo. (2) Volume to diameter relationship of the balloon (balloon configuration curve) was defined using an image analyzing computer. (3) Using the trachea of fetal sheep, pressures that break balloon tracheal seal (seal pressure) were investigated. Results: (1) Between 16 and 41 weeks' gestation, tracheal ID (range, 0.7 to 5.4 mm) correlates significantly with gestational age. (2) Balloon volume required to achieve tracheal seal could be determined based on the tracheal growth curve and the balloon configuration curve. (3) Tracheal seal breaking points varied depending on the tracheal specimen tested. Conclusion: Internal tracheal occlusion using a balloon is feasible with minimal tracheal damage if the balloon volume is adjusted to fetal tracheal growth. Copyright (C) 2000 by W.B. Saunders Company.
KW - Congenital diaphragmatic hernia
KW - Detachable silicone balloon
KW - Fetal trachea
KW - Fetendo clip
UR - http://www.scopus.com/inward/record.url?scp=0033763696&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033763696&partnerID=8YFLogxK
U2 - 10.1053/jpsu.2000.18311
DO - 10.1053/jpsu.2000.18311
M3 - Article
C2 - 11083424
AN - SCOPUS:0033763696
VL - 35
SP - 1566
EP - 1570
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 11
ER -