Surgeons in California performed a life-saving procedure on a tiny fetus inside a mother’s womb after practicing a few times on a grape and a jelly mold.
The team of doctors in Los Angeles used a wire the width of a hair, a balloon just a few millimeters wide and a needle measuring 11 centimeters to open up a narrow aortic valve in the walnut-sized heart of a 25-week-old fetus still growing in its mom’s belly, according to the Times.
Weeks before the Sept. 25 procedure, fetal cardiologist Dr. Jay Pruetz of Children’s Hospital Los Angeles diagnosed the fetus with severe aortic stenosis. The condition means the baby’s aortic valve was very tight, leading to blood being backed up and not being able to pump normally.
The doctors decided to perform what is known as fetal aortic valvuloplasty, a life-saving procedure. Had they not done so, the left ventricle would not develop properly, and the baby would likely be born with a life-threatening condition called hypoplastic left heart syndrome (HLHS), which can lead to breathing problems, weak pulse and a bluish skin color.
“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 Los Angeles Fetal Therapy, said. “Now the baby has a chance to have the left ventricle recover with some good function.”
The doctors practiced a few times with a model of jello and a grape, the grape standing in for the heart and the jello standing in for the surrounding body. The operation was performed at the CHA Hollywood Presbysterian Medical Center in Los Angeles, with the mother sedated. The baby was given anesthesia and a muscle relaxant so it wouldn’t switch positions.
The video below shows the tiny needle slowly being inserted into the beating heart up until the exact point of the narrow aortic valve, performed by Dr. Chmait.
Next, pediatric interventional cardiologist Dr. Frank Ing of CHLA, threaded a micro-wire through a tiny hole running inside the length of the needle. A tiny aortic balloon was then attached to a catheter was passed down along the wire and inflated to stretch the narrow aortic valve. The balloon, wire and needle were then all removed, leaving just the catheter in place.
Now, both the mother and fetus are doing well, according to the Times.
“It’s only been a week or two, but even initially after the procedure, we could see increased blood flow across the valve, and the heart was squeezing a bit better than before,” Dr. Pruetz said.
The procedure was the first of its kind in Southern California and the doctors relied on ultrasound imaging to see what they were doing.