Article Data

  • Views 3450
  • Dowloads 175

Review

Open Access

The application of ex utero intrapartum treatment (EXIT) procedure for cardiothoracic disorders

  • SHI-MIN YUAN1

1Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, Fujian Province, People’s Republic of China

DOI: 10.22514/SV141.052018.1 Vol.14,Issue 1,March 2018 pp.14-16

Published: 27 March 2018

*Corresponding Author(s): SHI-MIN YUAN E-mail: shi_min_yuan@yahoo.com

Abstract

The ex utero intrapartum treatment (EXIT) procedure was primarily devel-oped to reverse temporary tracheal occlu-sion in patients with fetal surgery for con-genital diaphragmatic hernia. Nowadays, it is widely used to resect fetal neck masses and to maintain an unobstructed airway. It is indicated for the management of several cardiothoracic diseases, including medi-astinal or lung mass resection, drainage of pleural effusions, palliative treatment of critical congenital heart disease and establishment of EXIT-to-extracorporeal membrane oxygenation (ECMO). EXIT has been attempted successfully in many centers, and it has been proven that moth-ers and babies tolerate the procedure well. Maternal and fetal surveillance during an-esthesia is important to maintain maternal blood pressure and placental blood flow and fetal oxygenation. The aim of this arti-cle is to discuss the application of the EXIT procedure for the management of fetal car-diothoracic diseases.

Keywords

anesthesia, fetus, mediastinal neoplasms, pleural effusion

Cite and Share

SHI-MIN YUAN. The application of ex utero intrapartum treatment (EXIT) procedure for cardiothoracic disorders. Signa Vitae. 2018. 14(1);14-16.

References

1. Hirose S, Harrison MR. The ex utero intrapartum treatment (EXIT) procedure. Semin Neonatol 2003;8(3):207-14.

2. Bouchard S, Johnson MP, Flake AW, Howell LJ, Myers LB, Adzick NS, Crombleholme TM. The EXIT procedure: experience and outcome in 31 cases. J Pediatr Surg 2002;37(3):418-26.

3. Liechty KW, Crombleholme TM, Flake AW, Morgan MA, Kurth CD, Hubbard AM, Adzick NS. Intrapartum airway management for giant fetal neck masses: the EXIT (ex utero intrapartum treatment) procedure. Am J Obstet Gynecol 1997;177(4):870-4.

4. Liechty KW. Ex-utero intrapartum therapy. Semin Fetal Neonatal Med 2010 Feb;15(1):34-9. doi: 10.1016/j.siny.2009.05.007.

5. Merchant AM, Hedrick HL, Johnson MP, Wilson RD, Crombleholme TM, Howell LJ, et al. Management of fetal mediastinal tera-toma. J Pediatr Surg 2005;40(1):228-31.

6. Agarwal A, Rosenkranz E, Yasin S, Swaminathan S. EXIT procedure for fetal mediastinal teratoma with large pericardial effusion: a case report with review of literature. J Matern Fetal Neonatal Med 2017 Apr 2:1-5. doi: 10.1080/14767058.2017.1306851. [Epub ahead of print]

7. Rychik J, Khalek N, Gaynor JW, Johnson MP, Adzick NS, Flake AW, Hedrick HL. Fetal intrapericardial teratoma: natural history and management including successful in uterosurgery. Am J Obstet Gynecol 2016;215(6):780.e1-780.e7.

8. Cass DL, Olutoye OO, Cassady CI, Zamora IJ, Ivey RT, Ayres NA, et al. EXIT-to-resection for fetuses with large lung masses and persistent mediastinal compression near birth. J Pediatr Surg 2013;48(1):138-44.

9. Benson CB. Fetal cardiac surgery and ex utero intrapartum treatment (EXIT) procedure. Ultrasound Med Biol 2003;29(5):S34.

10. Marwan A, Crombleholme TM. The EXIT procedure: principles, pitfalls, and progress. Semin Pediatr Surg 2006;15(2):107-15.

11. Matte GS, Connor KR, Toutenel NA, Gottlieb D, Fynn-Thompson F. A Modified EXIT-to-ECMO with Optional Reservoir Circuit for Use during an EXIT Procedure Requiring Thoracic Surgery. J Extra Corpor Technol 2016;48(1):35-8.

12. Mohan MS, Patole SK. Isolated fetal pericardial effusion: case report and review of the literature. Aust N Z J Obstet Gynaecol 2002;42(2):216-8.

13. Shenker L, Reed KL, Anderson CF, Kern W. Fetal pericardial effusion. Am J Obstet Gynecol 1989;160(6):1505-7;7-8.

14. Kern C, Ange M, Morales, Peiry B, Pfister RE. Ex utero intrapartum treatment (EXIT), a resuscitation option for intra-thoracic foetal pathologies. Swiss Med Wkly 2007;137(19-20):279-85.

15. Henry PY, Aravindan CS, Sivakumar K, Krishna HR. Extrauterine Intrapartum Treatment (EXIT) in bilateral primary fetal hydro-thorax. Indian J Pediatr 2009;76(1):99-101.

16. Prontera W, Jaeggi ET, Pfizenmaier M, Tassaux D, Pfister RE. Ex utero intrapartum treatment (EXIT) of severe fetal hydrothorax. Arch Dis Child Fetal Neonatal Ed 2002;86(1):F58-60.

17. Moldenhauer J, Endo M, Bebbington M, Adzick NS, Flake AW, Hedrick HL, et al. Maternal morbidity associated with the ex-utero intrapartum treatment (EXIT) procedure. Am J Obst Gynecol 2009;201(6):S164-5.

Abstracted / indexed in

Science Citation Index Expanded (SCIE) (On Hold)

Chemical Abstracts Service Source Index

Scopus: CiteScore 1.3 (2024)

Embase

Submission Turnaround Time

Top