Doctors in L.A. successfully perform heart operation on fetus
Practicing on a jelly mold and grape, procedure is showing signs of success
A medical first for the surgical team at CHA Hollywood Presbyterian Medical Center in Los Angeles, surgeons have successfully performed heart surgery on a fetus. According to newspaper report, it's the first time for the team, which practiced on a grape and jelly mold prior to the procedure..
The fetal heart was developing with one valve too narrow, known as severe aortic stenosis, meaning the amount of blood coming into the heart was being severely restricted, backing up in the left ventricle.
Surgeons used a hair-fine wire, a miniature needle, a tiny balloon and a catheter they successfully carried out the operation on the unborn child's heart, which was about the size of a walnut.
"There is no question in my mind that without this procedure the baby would have had HLHS," Dr. Ramen Chmait, assistant professor at Keck School of Medicine of USC and director of L.A. Fetal Therapy, said. "Now the baby has a chance to have the left ventricle recover with some good function."
Using a jelly mold to replicate the mother's body, a single grape representing the fetal heart was used as practice. The nerve-wracking operation was performed on September 25. The mother was given a local anesthetic; the fetus was likewise also given anesthesia and a muscle relaxant so it would not move in the mother's womb during the operation.
A video of the procedure shows the tiny needle being slowly inserted into the beating heart up until the exact point of the narrow aortic valve. This part of the procedure was performed by Dr. Chmait.
Pediatric intervention cardiologist Dr, Frank Ing then threaded a micro-wire, the same width as a hair, through a tiny hole running inside the length of the needle.
According to the Los Angeles, Times, a tiny aortic balloon attached to a catheter was passed down along the wire and inflated to a width of 3.25 mm, stretching and even tearing the narrow aortic valve.
The balloon, wire and needle were then all removed, leaving the catheter in place. sending more blood was flowing into the fetal heart.
While the procedure was a first for Southern California. It wasn't the first worldwide. Guy's and St Thomas' NHS Foundation Trust hospital, in London, was the first to carry out the procedure, at its Evelina London Children's Hospital, in 1989.
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