The Hospital Universitari i Politècnic La Fe in Valencia successfully carried out one for the first time in Spain surgical procedure to remove a heart tumor in a baby diagnosed in the fetal periodi.e. before birth.
It was a rare heart tumor called pericardial teratoma, which was observed in the 24th week of pregnancy (five and a half months) and was behaving aggressively, compressing the heart and nearby structures and threatening the life of the little girl and also the mother.
Given the complexity of the situation, the Fetal Malformations Commission of the Valencian Hospital, composed of specialists in obstetrics, neonatology, genetics, surgery, cardiology, neurology and pediatric radiology, carried out a comprehensive follow-up of the pregnancy.
Due to the characteristics of the tumor, the patient could die immediately after cutting the umbilical cord that connected her to her mother. Therefore, she had to remain attached to the placenta while she was stabilized and the surgical procedure began.
This committee initially decided on intrauterine treatment using obstetric techniques to relieve tumor compression to allow the baby to complete the weeks of pregnancy and avoid premature birth. In the 28th week of pregnancySo after six and a half months, and given the extreme severity, It is decided to remove the baby via cesarean sectionweighs only 900 grams.
Accordingly Raquel EscrigHead of the Department of Neonatology, “The complexity of the procedure arose from the fact that due to the characteristics of the tumor, the patient could die immediately after cutting the umbilical cord that connected her to the mother.” Therefore, it had to be on the placenta remain attached while it was stabilized and the surgical procedure began.”
This is the technique known as Ex Utero Intrapartum Treatment or EXIT.
surgical procedure
He The surgical team consisted of more than thirty professionals: a group for mothers with obstetric anesthesiology and specialists in obstetrics and gynecology; and the second for the baby, with neonatology, pediatric anesthesiology, pediatric surgery, pediatric cardiology and pediatric cardiac surgery, in the same operating room.
The operation was examined and rehearsed for several days, with the scenario being recreated through clinical simulation. It is the first time this type of surgery has been performed at La Fe Hospital.
This enabled the girl to be kept alive after the cesarean section Placenta help from his motherwhich enabled his intubation before umbilical cord clamping and his immediate surgical intervention to remove the life-threatening tumor.
“This is an exceptional case as it is a premature baby. There are only a few reports in the scientific literature of children with such low weight who have survived this type of heart tumor without consequences, he explains Sonia GarcesSpecialist in pediatric anesthesiology at Hospital La Fe.
The patient required repeat surgery two months later through the services of pediatric surgery, pediatric cardiac surgery, pediatric anesthesiology and the pediatric intensive care and resuscitation ward to remove remnants of the regrown tumor. After the same and two cycles of chemotherapy in pediatric oncology, he is free of the disease.