ENDOSCOPIC TRACHEAL OBSTRUCTION WITH AN EXPANDING DEVICE IN A FETAL LAMB MODEL - PRELIMINARY CONSIDERATIONS

Tracheal obstruction to promote lung growth may be a less aggressive a lternative to open fetal surgery in the antenatal treatment of congeni tal diaphragmatic hernia. Herein, we explore the feasibility of placin g an occluding device through fetal tracheoscopy. A self-expanding umb rella allowed adequate sealing of the tracheal lumen even as the trach eal diameter more than doubled between 110 and 138 days of gestation ( term = 145 days) in a sheep model. Distal intratracheal pressures afte r umbrella placement, and lung weight at delivery, were comparable to those after formal tracheal ligation.