Management of twin reversed arterial perfusion (TRAP) sequence with microwave ablation: A case report and review of the literature

Abstract

Twin reversed arterial perfusion (TRAP) sequence carries a high mortality risk to the “pump twin.” Management involves disrupting blood flow to the acardiac mass. In this case, the pregnant patient presented at 20 weeks 6 days with Stage IIb TRAP Sequence and underwent percutaneous ultrasound-guided microwave ablation (MWA) of the acardiac mass at 21 weeks 0 days. The probe traversed the thorax of the acardiac mass and ablated the confluence of the umbilical vessels. A healthy child was delivered at 33 weeks 5 days gestation. This report demonstrates the utility of MWA in TRAP sequence and describes a novel approach.