A team of 20-plus medical experts in the US achieved a medical first by successfully performing open-heart surgery on a baby within minutes of birth – and while still partially attached to his mother.
The unprecedented procedure, aimed at correcting a life-threatening congenital heart defect, marks the first successful case of its kind worldwide.
Megan Wild, from Chester, New York, was 20 weeks pregnant when doctors diagnosed her unborn son with hypoplastic left heart syndrome. This rare and severe condition causes the left side of the heart to develop improperly.
Typically, babies born with this condition undergo a series of surgeries after birth, beginning within the first week of life.
However, Megan’s baby faced an even more critical challenge: the lack of natural communication between the right and left sides of his heart significantly lowered his chances of survival.
Determined to give her baby the best possible chance, Megan chose to proceed with an innovative surgical approach that had previously been attempted twice globally, though never successfully.
The medical team at WMCHealth’s Maria Fareri Children’s Hospital and Westchester Medical Centre planned a complex ex-utero intrapartum treatment (EXIT) procedure, allowing them to operate on the baby’s heart while he was still partially inside his mother’s womb and connected to her circulatory system.
During the operation, Megan’s baby was partially delivered via Caesarean section, while the placenta and umbilical cord remained intact, enabling Megan to function as her baby’s heart-lung support.
Dr Sameh Said, a paediatric cardiac surgeon at Maria Fareri Children’s Hospital, performed the critical open atrial septostomy (OAS) procedure to improve blood flow between the heart’s chambers. Only after the successful completion of the surgery was the baby fully delivered.
Dr Said said: ‘In this case, the chance of Megan’s son surviving after a traditional birth and waiting until we performed the surgery to correct the defect was very slim. Even the transfer of the baby to another operating room or our cardiac catheterisation laboratory carried extremely high risks. Allowing the baby to remain bonded to Megan while we operated on his heart was critical in ensuring he had enough oxygen to support and stabilise his body through this emergent procedure.’
The baby, Luciano Reynaga III, was born at nearly full term and weighed 8 lbs and 1oz.
Less than 24 hours later, Dr Said conducted a second complex surgery, known as the Norwood procedure, to reconstruct Luciano’s aorta and convert his right ventricle into the primary pumping chamber.
While Luciano will require additional heart surgeries as he grows, Dr Said explained: ‘He will need additional follow-up heart surgeries to achieve normal oxygen saturation. But due to the success of this surgery, we expect Luciano to have a good quality of life.’
Megan-Wild-and-Luciano-Reynaga-III.Credit-Maria-Fareri-Childrens-Hospital
