In a groundbreaking procedure, physicians successfully performed in utero surgery to repair a rare and potentially fatal condition in a fetus. While in utero surgery has been utilized for other conditions in the past, this marks the first time it has been attempted to treat a specific abnormality known as “vein of Galen malformation” – a rare blood vessel abnormality within the brain that can result in a rush of high-pressure blood into the veins.
The details of this extraordinary procedure, carried out in March, were published in the peer-reviewed journal “Stroke” on Thursday. Stroke is affiliated with the American Stroke Association, a division of the American Heart Association. The surgery lasted for two hours when the fetus was at 34 weeks and 2 days gestational age. Doctors used ultrasound imaging to guide a needle through the mother’s uterus and into a vein at the back of the fetus’s head. Subsequently, a catheter within the needle was employed to insert tiny coils, mitigating blood flow in the vein.
This tiny patient is part of an ongoing clinical trial conducted by Boston Children’s Hospital and Brigham and Women’s Hospital. The trial is supervised by the U.S. Food and Drug Administration. Two days after the procedure, the baby was delivered via induced vaginal birth.
The parents of this miraculous baby, Derek and Kenyatta Coleman, shared their experience with CNN. They discovered their child’s condition during a 30-week ultrasound when the doctor notified them of abnormalities in the baby’s brain and an enlarged heart. Despite being aware of the potential risks associated with the clinical trial, the Colemans believed they had no other viable option.
Weeks later, doctors report that the Colemans’ baby daughter, Denver, is thriving and doing exceedingly well.
“In our first treated case, we were thrilled to observe the absence of the typically observed rapid decline after birth,” noted lead study author Dr. Darren B. Orbach in a press release. “At six weeks, the infant is progressing remarkably well without any medications, demonstrating normal eating habits, gaining weight, and has returned home. There are no indications of any adverse effects on the brain.”
Dr. Orbach emphasized that Denver is their first treated patient, underscoring the necessity of continuing the trial to evaluate safety and effectiveness in other patients. Nevertheless, the results thus far are promising.
“This approach has the potential to revolutionize the management of vein of Galen malformation,” said Dr. Orbach. “By repairing the malformation before birth and preemptively addressing the risk of heart failure, we may significantly reduce the long-term risks of brain damage, disability, and mortality in these infants.”
