A case of thoraco-amniotic shunt for congenital cystic adenomatoid malformation

Takeshi Yokoyama, Koichi Yamashita, Tomoki Nishiyama, Choku Yajima, Masanobu Manabe, Kazuo Hanaoka

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Congenital cystic adenomatoid malformation (CCAM) is a congenital pulmonary anomaly, which may lead to fetal hydrops, pulmonary hypoplasia, and fetal or neonatal death. Recently, diagnosis and surgery for fetus have been improved. We experienced a case of CCAM, classified in Stocker class I, with a single cyst of about 5 cm in diameter. A 32 year-old pregnant woman had a fetus diagnosed as CCAM at 25th gestational week. The thoraco-amniotic shunt placement using a modified double pig tail catheter was performed at 27th gestational week under general anesthesia with 1% isoflurane in oxygen 2 l · min-1 and nitrous oxide 4 l · min-1, and 100 μg of fentanyl. Fetal movement was suppressed during surgery. This fetal therapy was effective and the cyst disappeared after surgery. The baby was delivered with caesarian section under spinal anesthesia with 0.5% bupivacaine 2.5 ml. On the next day, right lung lobectomy was accomplished under general anesthesia with fentanyl 0.2 mg and pancuronium 6.0 mg. Anesthesia with isoflurane, nitrous oxide, and fentanyl was useful for the fetal surgery of thoracoamniotic shunt placement. Consequently, caesarian section and lung lobectomy were completed successfully.

Original languageEnglish
Pages (from-to)287-290
Number of pages4
JournalJapanese Journal of Anesthesiology
Issue number3
Publication statusPublished - Mar 2005
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine


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