Fetoscopic Endoluminal Tracheal Occlusion (FETO) versus Expectant Management for Severe Congenital Diaphragmatic Hernia at a Single Center
Abstract. Introduction: The TOTAL trial showed survival benefit in patients with severe congenital diaphragmatic hernia (CDH) who underwent fetoscopic endoluminal tracheal occlusion (FETO). We aim to add to the current literature by describing implementation, feasibility, and outcomes of patients treated with FETO compared to a contemporary cohort of expectantly managed maternal-child dyads. Methods: A single center, retrospective cohort study evaluated patients with a prenatal diagnosis of isolated left CDH with an observed/expected lung to head ratio < 30% referred to our center from September 2016 through January 2023. Results: Twelve patients who underwent FETO were compared to 35 expectantly managed patients. At initial evaluation, FETO patients had a lower O/E LHR value (21.7% versus 24.9%) compared to the expectant management patients. Chorioamniotic membrane separation occurred in half of the FETO patients (6/12) compared with one patient in the expectant management group and m
