In a procedure that is the first of its kind, doctors performed successful surgery in the womb to repair a rare and potentially fatal prenatal condition in a fetus. In utero surgery has been used for other conditions, but this is the first time it has been attempted to treat a ‘vein of Galen malformation’ – a rare blood vessel abnormality in the brain that can cause a high-pressure flow of blood into the veins. .
Details of the procedure, which was performed in March, were published Thursday in Stroke, the peer-reviewed journal of the American Stroke Association, a division of the American Heart Association. During a two-hour procedure, when the fetus was 34 weeks and 2 days gestational age, doctors used ultrasound to guide a needle through the mother’s uterus and into a vein in the back of the fetus’ head. A needle catheter was then used to insert small coils to reduce blood flow in the vein.
The tiny patient was the first in a clinical trial currently underway at Boston Children’s Hospital and Brigham and Women’s Hospital, conducted under the supervision of the U.S. Food and Drug Administration, and was delivered two days after the procedure through an induced vaginal delivery.
The baby’s parents, Derek and Kenyatta Coleman, told CNN that they learned about their child’s condition during a 30-week ultrasound, and that the doctor told them that “something was wrong in the baby’s brain, and also her heart wasn’t beating. increases.” Although Kenyatta said she was aware of the potential risks of participating in the clinical trial, “the Colemans felt there was no other option for them,” CNN wrote.
Weeks later, doctors say Denver, the Colemans’ daughter, is doing well.
“In our first treated case, we were delighted to see that the aggressive decline usually seen after birth simply did not occur,” said lead study author Dr. Darren B. Orbach in a press release. “We are pleased to report that at six weeks the baby is making remarkably good progress, taking no medications, eating normally, gaining weight and is back home. There are no signs of negative effects on the brain.”
Orbach added that this is only their first patient treated, and it is critical to continue the trial to assess safety and efficacy in other patients. Still, the results are promising.
“This approach has the potential to mark a paradigm shift in the treatment of vein of Galen malformations, where we repair the malformation before birth and prevent heart failure before it occurs, rather than trying to reverse it after birth make,” says Orbach. “This can significantly reduce the risk of long-term brain damage, disability or death in these babies.”
