Notas clínicas
Transfusión fetofetal y complicaciones cardiovasculares
Twin-twin transfusion syndrome and cardiovascular complications
P. Betrián Blasco
, J. Girona Comas, D.C. Albert Brotons
Autor para correspondencia
pedrobetrian@yahoo.es
Correspondencia: Dr. P. Betrián Blasco. Fraga, 18, 3.° C. 50003 Zaragoza. España.
Correspondencia: Dr. P. Betrián Blasco. Fraga, 18, 3.° C. 50003 Zaragoza. España.
Servicio de Cardiología Pediátrica. Hospital Maternoinfantil Vall d’Hebron. Barcelona. España
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Aldamiz-Echevarría Azuar, J.M. Prats Viñas, P. Sanjurjo Crespo, J.A. Prieto Perera, M.ªT. Labayru Echeverría" "autores" => array:5 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Aldamiz-Echevarría Azuar" ] 1 => array:2 [ "nombre" => "J.M." "apellidos" => "Prats Viñas" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Sanjurjo Crespo" ] 3 => array:2 [ "nombre" => "J.A." "apellidos" => "Prieto Perera" ] 4 => array:2 [ "nombre" => "M.ªT." "apellidos" => "Labayru Echeverría" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403305702551?idApp=UINPBA00005H" "url" => "/16954033/0000006300000006/v1_201307051457/S1695403305702551/v1_201307051457/es/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Notas clínicas</span>" "titulo" => "Transfusión fetofetal y complicaciones cardiovasculares" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "551" "paginaFinal" => "554" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "P. Betrián Blasco, J. Girona Comas, D.C. Albert Brotons" "autores" => array:3 [ 0 => array:4 [ "nombre" => "P." "apellidos" => "Betrián Blasco" "email" => array:1 [ 0 => "pedrobetrian@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Girona Comas" ] 2 => array:2 [ "nombre" => "D.C." "apellidos" => "Albert Brotons" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Cardiología Pediátrica. Hospital Maternoinfantil Vall d’Hebron. Barcelona. España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Dr. P. Betrián Blasco. Fraga, 18, 3.° C. 50003 Zaragoza. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Twin-twin transfusion syndrome and cardiovascular complications" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-12-31" "fechaAceptado" => "2005-08-31" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186300" "palabras" => array:4 [ 0 => "Miocardiopatía" 1 => "Hipertrofia" 2 => "Síndrome de transfusion fetofetal" 3 => "Embarazo gemelar" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186299" "palabras" => array:4 [ 0 => "Cardiomyopathy" 1 => "Hypertrophy" 2 => "Twin-twin transfusion syndrome" 3 => "Twin pregnancy" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p class="elsevierStyleSimplePara elsevierViewall">El síndrome de transfusión fetofetal presenta una importante morbimortalidad, en parte debida a las alteraciones cardiovasculares que genera.</p> <span class="elsevierStyleSectionTitle">Casos clínicos</span><p class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Paciente 1</span>. Se realiza cesárea en la semana 28 por disfunción miocárdica e insuficiencia tricuspídea grave en el feto receptor. A las 12 h de vida, el feto receptor desarrolla un shock refractario. Se objetiva hipertrofia biventricular grave, que acaba en fallecimiento a las 60 h de vida en fallo multiorgánico.</p><p class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Paciente 2</span>. Se practica cesárea en la semana 29 por cardiomegalia e insuficiencia cardíaca congestiva. Al nacer presenta mala perfusión periférica e hipertensión. Se objetiva hipertrofia biventricular que progresa hasta generar una estenosis medioventricular derecha ligera a las 72 h. Se inicia regresión al octavo día y persiste ligera hipertrofia a los 6 meses.</p> <span class="elsevierStyleSectionTitle">Discusión</span><p class="elsevierStyleSimplePara elsevierViewall">Las alteraciones cardíacas en el síndrome de transfusion fetofetal aparecen sólo en los fetos receptores. Los hallazgos más frecuentes son la existencia de dilatación, hipertrofia, disfunción miocárdica, insuficiencia tricuspídea y estenosis pulmonar. Estas alteraciones suelen regresar con los meses, pudiendo también empeorar.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStyleSimplePara elsevierViewall">Twin-twin transfusion syndrome carries high morbidity and mortality, related in part to the cardiovascular alterations that it produces.</p> <span class="elsevierStyleSectionTitle">Case report</span><p class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Patient 1</span> underwent a cesarian section at week 28 due to myocardial dysfunction and severe tricuspid regurgitation in the recipient twin. Twelve hours after birth the recipient twin developed refractory shock. Severe biventricular hypertrophy was observed and the twin died 60 hours after birth from multisystemic failure.</p><p class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Patient 2</span> underwent a cesarian section at week 29 due to cardiomegaly and cardiac insufficiency in the recipient twin. At birth, he showed hypertension and poor peripheral perfusion. Biventricular hypertrophy was observed, which increased until it produced a mild right midventricular stenosis at 72 hours, decreasing after the 8th day. Mild hypertrophy persisted at 6 months of life.</p> <span class="elsevierStyleSectionTitle">Discussion</span><p class="elsevierStyleSimplePara elsevierViewall">Cardiovascular alterations appear only in recipient fetuses affected by twin-twin transfusion syndrome. The most frequent findings are cardiac dilation, hypertrophy, myocardial dysfunction, tricuspid regurgitation and pulmonary stenosis. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 9 | 23 | 32 |
| 2024 Octubre | 53 | 77 | 130 |
| 2024 Septiembre | 57 | 63 | 120 |
| 2024 Agosto | 55 | 113 | 168 |
| 2024 Julio | 36 | 63 | 99 |
| 2024 Junio | 42 | 66 | 108 |
| 2024 Mayo | 49 | 64 | 113 |
| 2024 Abril | 39 | 51 | 90 |
| 2024 Marzo | 31 | 65 | 96 |
| 2024 Febrero | 30 | 52 | 82 |
| 2024 Enero | 26 | 57 | 83 |
| 2023 Diciembre | 27 | 35 | 62 |
| 2023 Noviembre | 23 | 40 | 63 |
| 2023 Octubre | 26 | 31 | 57 |
| 2023 Septiembre | 22 | 25 | 47 |
| 2023 Agosto | 20 | 28 | 48 |
| 2023 Julio | 35 | 55 | 90 |
| 2023 Junio | 26 | 63 | 89 |
| 2023 Mayo | 30 | 29 | 59 |
| 2023 Abril | 22 | 13 | 35 |
| 2023 Marzo | 24 | 36 | 60 |
| 2023 Febrero | 18 | 20 | 38 |
| 2023 Enero | 26 | 27 | 53 |
| 2022 Diciembre | 39 | 31 | 70 |
| 2022 Noviembre | 41 | 45 | 86 |
| 2022 Octubre | 26 | 65 | 91 |
| 2022 Septiembre | 24 | 46 | 70 |
| 2022 Agosto | 40 | 70 | 110 |
| 2022 Julio | 78 | 51 | 129 |
| 2022 Junio | 28 | 50 | 78 |
| 2022 Mayo | 32 | 43 | 75 |
| 2022 Abril | 28 | 51 | 79 |
| 2022 Marzo | 35 | 48 | 83 |
| 2022 Febrero | 23 | 33 | 56 |
| 2022 Enero | 34 | 49 | 83 |
| 2021 Diciembre | 26 | 60 | 86 |
| 2021 Noviembre | 27 | 60 | 87 |
| 2021 Octubre | 34 | 71 | 105 |
| 2021 Septiembre | 27 | 67 | 94 |
| 2021 Agosto | 19 | 37 | 56 |
| 2021 Julio | 29 | 44 | 73 |
| 2021 Junio | 30 | 51 | 81 |
| 2021 Mayo | 31 | 33 | 64 |
| 2021 Abril | 67 | 98 | 165 |
| 2021 Marzo | 56 | 63 | 119 |
| 2021 Febrero | 55 | 48 | 103 |
| 2021 Enero | 41 | 41 | 82 |
| 2020 Diciembre | 55 | 42 | 97 |
| 2020 Noviembre | 21 | 35 | 56 |
| 2020 Octubre | 18 | 32 | 50 |
| 2020 Septiembre | 13 | 14 | 27 |
| 2020 Agosto | 23 | 11 | 34 |
| 2020 Julio | 22 | 18 | 40 |
| 2020 Junio | 15 | 16 | 31 |
| 2020 Mayo | 48 | 13 | 61 |
| 2020 Abril | 44 | 14 | 58 |
| 2020 Marzo | 57 | 10 | 67 |
| 2020 Febrero | 48 | 23 | 71 |
| 2020 Enero | 15 | 21 | 36 |
| 2019 Diciembre | 43 | 31 | 74 |
| 2019 Noviembre | 21 | 7 | 28 |
| 2019 Octubre | 10 | 20 | 30 |
| 2019 Septiembre | 13 | 12 | 25 |
| 2019 Agosto | 33 | 21 | 54 |
| 2019 Julio | 22 | 44 | 66 |
| 2019 Junio | 19 | 29 | 48 |
| 2019 Mayo | 33 | 20 | 53 |
| 2019 Abril | 34 | 45 | 79 |
| 2019 Marzo | 17 | 16 | 33 |
| 2019 Febrero | 16 | 11 | 27 |
| 2019 Enero | 12 | 18 | 30 |
| 2018 Diciembre | 16 | 19 | 35 |
| 2018 Noviembre | 27 | 25 | 52 |
| 2018 Octubre | 39 | 30 | 69 |
| 2018 Septiembre | 16 | 15 | 31 |
| 2018 Julio | 3 | 0 | 3 |
| 2018 Junio | 2 | 0 | 2 |
| 2018 Mayo | 2 | 0 | 2 |
| 2018 Abril | 10 | 0 | 10 |
| 2018 Marzo | 3 | 0 | 3 |
| 2018 Febrero | 5 | 0 | 5 |
| 2018 Enero | 3 | 0 | 3 |
| 2017 Diciembre | 7 | 0 | 7 |
| 2017 Noviembre | 8 | 0 | 8 |
| 2017 Octubre | 7 | 0 | 7 |
| 2017 Septiembre | 10 | 0 | 10 |
| 2017 Agosto | 8 | 0 | 8 |
| 2017 Julio | 6 | 0 | 6 |
| 2017 Junio | 13 | 24 | 37 |
| 2017 Mayo | 15 | 17 | 32 |
| 2017 Abril | 14 | 20 | 34 |
| 2017 Marzo | 11 | 28 | 39 |
| 2017 Febrero | 11 | 13 | 24 |
| 2017 Enero | 10 | 10 | 20 |
| 2016 Diciembre | 14 | 8 | 22 |
| 2016 Noviembre | 26 | 10 | 36 |
| 2016 Octubre | 33 | 14 | 47 |
| 2016 Septiembre | 42 | 14 | 56 |
| 2016 Agosto | 23 | 4 | 27 |
| 2016 Julio | 14 | 5 | 19 |
| 2016 Marzo | 3 | 0 | 3 |
| 2016 Febrero | 1 | 6 | 7 |
| 2016 Enero | 1 | 0 | 1 |
| 2015 Diciembre | 1 | 0 | 1 |
| 2015 Noviembre | 2 | 0 | 2 |
| 2015 Octubre | 3 | 0 | 3 |
| 2015 Septiembre | 3 | 0 | 3 |
| 2015 Agosto | 0 | 11 | 11 |
| 2015 Julio | 9 | 0 | 9 |
| 2015 Junio | 8 | 1 | 9 |
| 2015 Mayo | 13 | 0 | 13 |
| 2015 Abril | 11 | 5 | 16 |
| 2015 Marzo | 22 | 0 | 22 |
| 2015 Febrero | 15 | 9 | 24 |
| 2015 Enero | 9 | 4 | 13 |
| 2014 Diciembre | 23 | 4 | 27 |
| 2014 Noviembre | 23 | 2 | 25 |
| 2014 Octubre | 20 | 4 | 24 |
| 2014 Septiembre | 24 | 3 | 27 |
| 2014 Agosto | 31 | 3 | 34 |
| 2014 Julio | 48 | 2 | 50 |
| 2014 Junio | 43 | 5 | 48 |
| 2014 Mayo | 50 | 6 | 56 |
| 2014 Abril | 39 | 1 | 40 |
| 2014 Marzo | 50 | 8 | 58 |
| 2014 Febrero | 45 | 15 | 60 |
| 2014 Enero | 40 | 13 | 53 |
| 2013 Diciembre | 37 | 9 | 46 |
| 2013 Noviembre | 29 | 5 | 34 |
| 2013 Octubre | 44 | 8 | 52 |
| 2013 Septiembre | 34 | 11 | 45 |
| 2013 Agosto | 41 | 11 | 52 |
| 2013 Julio | 28 | 5 | 33 |
| 2013 Junio | 3 | 2 | 5 |
| 2013 Mayo | 2 | 2 | 4 |
| 2013 Abril | 5 | 1 | 6 |
| 2013 Marzo | 4 | 2 | 6 |
| 2013 Febrero | 11 | 1 | 12 |
| 2013 Enero | 22 | 0 | 22 |
| 2012 Diciembre | 12 | 0 | 12 |
| 2012 Noviembre | 6 | 0 | 6 |
| 2012 Octubre | 2 | 1 | 3 |
| 2012 Septiembre | 2 | 1 | 3 |
| 2005 Diciembre | 3526 | 0 | 3526 |
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