ArticleUltrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology2021
Safety and efficacy of smart tracheal occlusion device in diaphragmatic hernia lamb model.
Article in Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 34 citations in OpenAlex.
- Randomized Trial of Fetal Surgery for Moderate Left Diaphragmatic Hernia.The New England journal of medicine · 2021Trial
- Using simulation to prepare multidisciplinary teams and clinical environments for complex fetal interventions and resuscitation.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Fetal Endoscopic Tracheal Occlusion (FETO) for Left and Right Congenital Diaphragmatic Hernia in Canada.Prenatal diagnosis · 2025Article
- Observed/Expected Lung-To-Head Ratio and Total Lung Volumes That Identify Fetuses With Severe Congenital Diaphragmatic Hernia in a North American Fetal Center.Prenatal diagnosis · 2025Article
- Impact of fetal treatments for congenital diaphragmatic hernia on lung development.Anatomical record (Hoboken, N.J. : 2007) · 2025Review
- The Ex-utero intrapartum treatment procedure: a narrative review.Frontiers in pediatrics · 2025Review
- End-tidal concentration of sevoflurane for optimal surgical conditions in pregnant sheep: a pragmatic approach to a retrospective observational study.The Journal of veterinary medical science · 2024Article
- Fetal therapy for congenital diaphragmatic hernia: past, present and future.World journal of pediatric surgery · 2024Review
- Article
- Intact cord resuscitation in newborns with congenital diaphragmatic hernia: insights from a lamb model.Frontiers in pediatrics · 2023Article
- Lifesaving Treatments for the Tiniest Patients-A Narrative Description of Old and New Minimally Invasive Approaches in the Arena of Fetal Surgery.Children (Basel, Switzerland) · 2022Review
- The Cellular and Molecular Effects of Fetoscopic Endoluminal Tracheal Occlusion in Congenital Diaphragmatic Hernia.Frontiers in pediatrics · 2022Review
- Fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia: a narrative review of the history, current practice, and future directions.Translational pediatrics · 2021Review
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 3 countries.
Funding
Abstract
objectiveTo investigate the efficacy and safety of the 'smart' tracheal occlusion (Smart-TO) device in fetal lambs with diaphragmatic hernia (DH).
methodsDH was created in fetal lambs on gestational day 70 (term, 145 days). Fetuses were allocated to either pregnancy continuation until term (DH group) or fetoscopic endoluminal tracheal occlusion (TO), performed using the Smart-TO balloon on gestational day 97 (DH + TO group). On gestational day 116, the presence of the balloon was confirmed on ultrasound, then the ewe was walked around a 3.0-Tesla magnetic resonance scanner for balloon deflation, which was confirmed by ultrasound immediately afterwards. At term, euthanasia was performed and the fetus retrieved. Efficacy of occlusion was assessed by the lung-to-body-weight ratio (LBWR) and lung morphometry. Safety parameters included tracheal side effects assessed by morphometry and balloon location after deflation. The unoccluded DH lambs served as a comparator.
resultsSix fetuses were included in the DH group and seven in the DH + TO group. All balloons deflated successfully and were expelled spontaneously from the airways. In the DH + TO group, in comparison to controls, the LBWR at birth was significantly higher (1.90 (interquartile range (IQR), 1.43-2.55) vs 1.07 (IQR, 0.93-1.46); P = 0.005), while on lung morphometry, the alveolar size was significantly increased (mean linear intercept, 47.5 (IQR, 45.6-48.1) vs 41.9 (IQR, 38.8-46.1) μm; P = 0.03); whereas airway complexity was lower (mean terminal bronchiolar density, 1.56 (IQR, 1.0-1.81) vs 2.23 (IQR, 2.14-2.40) br/mm
conclusionsIn fetal lambs with DH, TO using the Smart-TO balloon is effective and safe. Occlusion can be reversed non-invasively and the deflated intact balloon expelled spontaneously from the fetal upper airways. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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