British newspaper "The Times" stated, in a report published Thursday, May 4, 2023, that surgeons performed an operation on the brain of a baby girl in her mother's womb; To correct a potentially fatal blood vessel malformation, in the first surgery of its kind.
Doctors were able to treat a congenital malformation known as "Galenian vein malformation", deep in the brain of the fetus. Babies with this condition often develop heart failure and stroke-like symptoms within days of birth. According to Great Ormond Street Hospital, the condition affects around 10 to 12 babies in the UK each year, and 6 weeks after surgery, the baby looks pretty good.
Galenic vein malformation occurs when there are abnormal connections between the arteries that carry blood to the brain under high pressure, and the veins that drain it away again.
The tiny capillaries that normally distribute oxygen-rich blood throughout the brain are missing in this condition. These capillaries normally intercept and slow the blood flow to the brain, but their absence leads to a rush of blood with great force. A lack of resistance can cause the heart to work harder than it should. This can lead to heart failure, and this can cause serious brain injuries as well.
The operation was performed on a 34-week-old fetus; Where a needle was inserted into his mother's womb and ultrasound images were used to guide them through the back of the fetus's head.
The needle is then used to place a catheter into the connecting abnormal blood vessel and insert a special metal coil to reduce the width of the blood vessel. Thus slowing blood flow. The operation took less than two hours, and the mother and fetus were under anesthesia. The baby was born prematurely, two days after the operation.
The first surgery of this kind
Dr. Darren Auerbach, the lead surgeon on the operation from Boston Children's Hospital, said the placenta — which nourishes babies — protects people with a GAV while they're in the womb. But after they are born, their condition usually deteriorates very quickly.
The doctor explained: "We treat a lot of children with malformed gallinus veins. They usually get very sick, need to have a catheter delivered right away, and end up on a breathing tube for weeks or months while we perform these high-risk operations. They get medication to support their heart function, They also have really high mortality and long-term morbidity."
By contrast, his latest patient is doing “fantastically well.” Orbach added: “She was in good health from birth. She didn't need any medicine to support her heart, nor a breathing tube. She was born a little premature. So she was put under observation in a unit.” NICU for a few weeks, where she was given intensive feeding until she gained enough weight. But now she's home and doing great."
He continued, “While this is our first treated patient, and it is essential that we continue the trial to assess safety and efficacy in other patients, this approach has the potential to transform the management of Galenic malformation by repairing the deformity before birth and preventing heart failure before it occurs, rather than than trying to reverse its consequences after childbirth."
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