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10.01.2019 13:13:46
Doctors at the Johann Kepler University Hospital in Linz for the first time in the world installed a stent in the heart of a child a few days before his birth. Little Jan, otherwise unsustainable, could be saved only with the help of a very risky emergency operation, he will have another operation, then he will be able to lead an almost normal life, as medics expect.
Four months after birth, Jan was the central theme of the press conference, at which Gerald Tulzer, the head of the pediatric cardiology clinic, and Wolfgang Arzt, the head of the prenatal medicine institute, explained the course and characteristics of the operation. Parents had only two or three days to decide to take this step. “We decided on this,” says the mother of the baby with the baby in her arms. “Thank God, it was the right choice,” the child’s father says with relief.
A still unborn child was diagnosed with hypoplasia of the left heart. At the same time, an important connection in the heart was blocked. The blood coming from the lungs could not pass from the atrium to the ventricle, which would have caused the child to be unviable after birth. According to Tulzer and Artst, before the birth, the mother for the child was in fact the "apparatus of artificial blood circulation." To resolve this difficult situation, the doctors installed a small stent, nine millimeters long, and three millimeters in diameter, in the womb. This stent provides blood flow.
With an operation six days before delivery, Jan was viable after birth. Currently, two operations have been performed, and another is needed. Probably, the heart of the newborn will not be able to endure the full load, like other people, but the child "will be able to lead an almost full life," says Tulzer.
The operation lasted about 30 minutes, but it required skill from the doctors. Under the control of ultrasound, they had to not only precisely manipulate the needle through the abdominal wall of the mother in the heart of the child, but at the same time to count the actions, taking into account that the child swims in the amniotic fluid, and the heart beats.
The operation carried out in Linz is the first such intervention in the whole world, carried out shortly before birth. Although in the USA and Canada there have already been several attempts at stenting in the womb, but they have never done it so close to childbirth. The fact that it was possible in Linz, Tulzer and Artst is explained by their interdisciplinary cooperation. According to the hospital, the pediatric cardiology center is the largest in Europe and the second largest in the world for prenatal cardiac surgery. Together with the Institute of Prenatal Medicine, 150 such operations have already been performed at the Center.
