2024-03-26 15:31:03
A surgical team of more than thirty professionals from the La Fe hospital in Valencia has successfully operated on a baby who was still in the gestation period to remove a cardiac tumor that put her life and that of the mother at risk, in the first operation of this type that is carried out in Spain.
Image of the surgical intervention of a cardiac tumor on a premature baby with her mother at her side. PHOTO: La Fe Hospital in Valencia.
It was a rare cardiac tumor known as pericardial teratoma diagnosed in the 24th week of gestation (five and a half months) and which behaved aggressively, compressing the heart and neighboring structures, therefore, threatening the life of the baby and also from the mother, as explained by the Department of Health.
Given the complexity of the situation, an exhaustive follow-up of the pregnancy for the commission of fetal malformations was carried out by a multidisciplinary group made up of specialists in obstetrics, neonatology, genetics, surgery, cardiology, neurology and pediatric radiology.
This committee initially decided on intrauterine management with obstetrics performing techniques to relieve tumor compression in order for the baby to complete weeks of gestation and avoid premature birth.
In the 28th week of gestation (six and a half months), given the extreme severity, it was decided to extract the baby by cesarean section, weighing only 900 grams.
Umbilical cord complication
The complexity of the procedure was given by the fact that, due to the characteristics of the tumor, the patient could die immediately after cutting the umbilical cord that held her to the mother, so she had to be kept attached to the placenta while it was stabilized at the patient and the surgical procedure began, using the EXIT (Ex Utero Intrapartum Treatment) technique, as explained by the head of the Neonatology section, Raquel Escrig.
More than thirty professionals, consisting of two complete surgical teams, one for the mother and the second for the baby, participated in the study and rehearsal of surgery through clinical simulation.
After the cesarean section, the girl was kept alive thanks to the placental assistance provided by her mother, allowing her to be intubated prior to clamping the umbilical cord and her immediate surgical intervention to remove the tumor that was compromising her life.
New intervention and chemotherapy
The patient required a new intervention two months later to remove remains of the tumor that had grown again. After this and two cycles of chemotherapy in children’s oncology, the baby is free of the disease.
As stated by the manager of the Hospital La FeJosé Luis Poveda, “the coordination and experience of the professionals at our hospital have been the key to the success of this operation. “This was a very complex challenge that represents a fundamental milestone in the treatment of cardiac tumors in premature babies.”
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