Double Wow! Heart Valve Surgery On A Fetus!
May 19th, 2009I just read a very interesting story at Canada.com about heart valve surgery on a fetus. To some extent, my jaw dropped to the ground as I learned about the surgical procedure used to save little Oceane McKenzie. Here are the highlights:
In what’s being called a Canadian first, Toronto doctors have successfully performed a life-saving heart procedure on a fetus inside her mother’s womb. A team of doctors at the Hospital for Sick Children and Mount Sinai Hospital used an ultrasound-guided balloon catheter to begin repairing one of the baby’s heart valves, which wasn’t developing properly.
Oceane McKenzie – In Utero Heart Valve Surgery Patient
During the 37-minute procedure, doctors inserted the device through the mother’s abdomen and then directly into the baby’s heart to induce proper growth and function – and to prevent the child from dying of heart failure at birth.
Oceane McKenzie, born April 15, is now doing well and expected to lead a normal childhood.
“Finally after two months, we can say we’re a lot more relaxed and confident that she is going to be home and live a normal life,” said Vicki McKenzie, cuddling her three-week-old daughter as sons Gavin, 7, and Owen, 4, played nearby. “From the moment I found out till about a week ago, I never thought she was going to live. But I do now.”
At 30 weeks into her pregnancy, McKenzie had an ultrasound that showed her developing fetus had critical aortic stenosis, a condition in which the main outlet valve of the left ventricle is severely narrowed. She was immediately referred to Toronto, where doctors at Sick Kids and Mount Sinai explained to the couple that waiting to operate after Oceane’s birth would be too risky.
Untreated, her condition would inevitably lead to a lifelong condition called hypoplastic left heart syndrome (HLHS). Children with HLHS typically need to have at least three major heart surgeries and are not expected to have a normal lifespan; the 10-year survival rate is only 65 percent.
“So what we offered the parents is the intervention where the baby’s still in the womb,” said Dr. Edgar Jaeggi, head of the fetal cardiac program at Sick Kids. “It’s a very high-risk procedure to do after birth, and we felt it was better to do during the pregnancy.”
The procedure allowed Oceane to remain safely in her mother’s womb for a crucial extra month until delivery. Dr. Greg Ryan, chief of the fetal medicine unit at Mount Sinai, said the operation offers little danger to the mother, although it can pose significant risks to the fetus.
“You could kill the baby, the baby could bleed to death, the baby could go into an irregular heartbeat,” explained Ryan, adding that the doctors are excited and heartened by the successful outcome. “I think it opens up all sorts of opportunities for the future … it’s something we can offer to other babies,” he said. “I think the important thing is getting the message out to the referring physicians that this is something that’s now available in Canada.”
The in-utero procedure, called balloon dilation of critical aortic stenosis in the fetus, has been tried by only a few centres in the world. Previous attempts by the Toronto team to perform the procedure on other fetuses with more advanced valve abnormalities were not successful and the babies did not survive.
“Modern science, modern medicine is amazing,” said Vicki McKenzie. “And we’re so happy it was able to give us a chance to be a family of five.”
Keep on tickin’ Oceane!
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| About The Author: Adam Pick is a double, heart valve surgery patient and author of The Patient's Guide To Heart Valve Surgery. This unique book integrates clinical research with the personal experiences of 135 former patients to help future patients and their caregivers better understand the problems, the opportunities and the realities of heart valve surgery. To learn more about Adam and his heart valve surgery book, click here. |
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