Subject: The First Time in Iran-Microwave Ablation of Acardiac Twin by SUMS Physicians
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Shiraz University of Medical Sciences - SUMS 
Code : 18322-87      Publish Date : Wednesday, February 19, 2020 Visit
: 3902 

NEWS | The First Time in Iran-Microwave Ablation of Acardiac Twin by
SUMS Physicians 

The First Time in Iran-Microwave Ablation of Acardiac Twin by SUMS
Physicians 
The First Time in Iran-Microwave Ablation of Acardiac Twin by SUMS
Physicians 

The First Time in Iran-Microwave Ablation of Acardiac Twin by SUMS
Physicians

-Microwave Ablation of Acardiac Twin by SUMS Physicians

Acardiac twinning or twin reversed arterial perfusion (TRAP) sequence
is one of the rarest complications of monochorionic twin pregnancies
where intrafetal therapy is crucial to prevent fetal demise. Dr.
Homeira Vafaiee, the head of Perinatology Department at Shiraz
University of Medical Sciences (SUMS), explained that TRAP sequence
occurs in approximately 1% of monochorionic twin pregnancies in which
one twin is usually structurally normal while the other is severely
malformed and is only an abnormal mass of tissue whose blood
circulatory system is connected to the normal fetus called “pump twin”.
The abnormal twin or the “acardiac twin” and the “pump twin” are
connected via unique vascular connections; arterio-arterial
anastomosis, on the surface of the shared placenta. The acardiac twin
lacks a beating heart; thus, the pump twin derives blood through both
fetus which causes an extra burden on the pump twin and consequently
contributes to heart failure.  If any urgent treatment, therefore, is
not taken into account, it is proved that intrauterine fetal death
occurs in approximately 30% of pump twins.

She continued that to ablate the acardiac twin so as to rule out
abnormalities in the pump twin and to avert its death, different
procedures including Microwave ablation, fetoscopic cord occlusion,
radio-frequency ablation, or laser ablation are administered. Among the
aforementioned methods, Microwave ablation is the most successful one
which increases the survival chance of the pump twin to about 80%.  As
Dr. Vafaiee remarked, for the first time in Iran, Microwave ablation
was carried out on a 26-year old woman pregnant with an acardiac twin
pregnancy. She maintained that Microwave ablation as the least invasive
procedure that greatly reduces the operation time was chosen for this
ideal candidate. During the operation, the artery blood flow of the
acardiac twin was occulted by the microwave laser device for 3 minutes.
Post operation procedure reveals a complete block of blood flow in the
acardiac twin and the successful survival of the pump twin. The
operation was performed at SUMS central Hospital by SUMS surgeons
including Dr. Homeira Vafaiee, Dr. Nasrin Asadi, Dr. Saman Nik-eghbal,
Dr. Shohreh Roozmah, Dr. Maryam Kasraian, Dr. Hamid Reza Forootan, Dr.
Azam Faraji, and Dr. Mitra Mehrban, Dr. Vafaiee concluded.