For the first time, doctors have surgically repaired malformed blood vessels in the brain of an in-utero baby. Babies born in mid-March were discharged from the hospital a few weeks after birth and have not needed any medications or other treatments ever since.
“It was the first time I heard her cry and I can’t even put into words how I felt in that moment,” said Kenyatta Coleman, the baby’s mother of Baton Rouge, Louisiana. told CNN (opens in new tab)“Being able to hold her, look up at her, and hear her cry was just the most beautiful moment.”
In a new report published Thursday (May 4) in the journal stroke (opens in new tab)the doctor described the first procedure of its kind. ongoing clinical trials (opens in new tab)The trial aims to find new treatments Galenic venous malformation (opens in new tab) (VOGM) is a rare disorder that affects the blood vessels that carry oxygenated blood from the heart to the brain.
In VOGM, certain arteries in the brain are not connected to capillaries (fine, branched blood vessels that help slow blood flow). Instead, the arteries pump blood into the veins at the base of the brain, and this blood flows at high pressure. , or may cause enlargement of the head (hydrocephalus).
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VOGM affects an estimated 1 in 60,000 live births. American Heart Association Statement (opens in new tab) (ah). Standard treatment is postnatal, blocking arterial and venous connections within the malformation. However, this procedure cannot always reverse the onset of heart failure.
Doctors at Boston Children’s Hospital and Boston’s Brigham and Women’s Hospital have begun trials to treat VOGM early while the fetus is still in the womb. A new approach uses intrauterine surgery designed to reduce aggressive blood flow through the VOGM. In total, an estimated 20 babies were included in the trial, with the most recently treated baby, Denver Coleman, being the first to undergo surgery.
“We were thrilled that our first treatment case did not show any of the rapid decline that is usually seen after birth.” Dr. Darren Orbach (opens in new tab)He is co-director of the Center for Cerebrovascular Surgery and Intervention at Boston Children’s Hospital, associate professor of radiology at Harvard Medical School, and lead author of the case report.
“At six weeks, I am pleased to report that the infant is doing very well, is off medication, is eating normally, is gaining weight, and is home.” There are no signs.”
Denver and Kenyatta Coleman underwent “transuterine” surgery at 34 weeks and two days pregnant. (VOGM was diagnosed shortly after a 30-week ultrasound, according to CNN.)
After surgery, Kenyatta Coleman started leaking amniotic fluid. This meant her “water started to break down,” so her doctors said she delivered her baby two days later via vaginal delivery. The newborn did not require cardiovascular support or surgery after birth, but she was monitored in the neonatal intensive care unit for several weeks before discharge.
“While this is our first treated patient and it is important to continue the trial to assess safety and efficacy in other patients, this approach marks a paradigm shift in the management of veins in Galen malformation.” Instead of trying to reverse heart failure postnatally, repair the malformation prenatally and avoid heart failure before it occurs.”