In a unique procedure, doctors performed successful uterine surgery to repair a rare and potentially deadly 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 “vein of Galen malformation” – a rare blood vessel abnormality in the brain that can cause a rush of high-pressure 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 pass a needle through the mother’s uterus and into a vein in the back of the fetus’ head. A catheter in the needle 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 born by birth two days after the procedure. 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 her heart was enlarged.” 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 writes.
Weeks later, doctors say Colemans’ daughter, Denver, is doing well.
“In our first treated case, we were thrilled to see that the aggressive decline usually seen after birth just didn’t show up,” said lead study author Dr. Darren B. Orbach in a press release. “We are pleased to report that at six weeks the baby is progressing remarkably well, taking no medication, 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 vital 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 managing vein of Galen malformation, where we repair the malformation before birth and prevent heart failure before it occurs, rather than trying to reverse it after birth, said Orbach. “This could significantly reduce the risk of long-term brain damage, disability or death in these babies.”