Doctors at Boston Children’s Hospital and Massachusetts General Hospital, both in the United States, performed unprecedented brain surgery to save a baby who was still inside the mother’s womb. The procedure was documented in an article published last Wednesday (3/5) in the journal Stroke by the American Heart Association.
The baby was diagnosed with aneurysmal malformation of the vein of Galen (VGAM) – a dilation of the most important vessel in the deep venous system – at 34 weeks. According to the doctors, he had a curved vein in his brain.
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In this situation, the arteries in the brain drain blood directly into the veins rather than through the capillaries, which can increase the volume of fluid in the heart, resulting in increased blood pressure. The extremely rare disease leads to the death of 30% of children born with the condition before they turn 11.
Surgery
With the help of an ultrasound examination, the doctors were able to identify the exact position of the diseased artery and made a cut in the pregnant woman’s uterus. From there, they accessed the baby’s skull to operate on the developing brain. A coil was implanted next to the artery to restrict blood flow.
According to Dr Darren Orbach, a surgeon at Children’s Hospital Boston, the pre-delivery approach can significantly reduce the risk of long-term brain damage, disability or death among children with the disease.
“This approach has the potential to mark a paradigm shift in the treatment of the vein of Galen malformation. We did the repair before birth and we prevented heart failure before it occurred, rather than trying to reverse it later,” Orbach said.
The surgery was successful and the woman was able to deliver the baby two days later in an induced labor. He was born without heart or brain problems, doctors said. MRI scans taken three weeks later also found no signs of abnormal blood flow in the brain.
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“We are pleased to report that at six weeks, the baby is progressing remarkably well, off medication, eating normally, gaining weight and coming home. There are no signs of any negative effects on the brain,” the team states in the article.
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