Pioneering procedure: Treating a fetal brain disease to save lives.

Doctors performed a life-saving operation, the first of its kind, when they managed to repair an abnormal artery in the brain of a 34-week-old fetus in the womb.

American doctors treated the fatal vein in the fetus, preventing heart failure and stroke shortly after birth.

There have been brain surgeries in the womb before, but not for this rare disease called Gallen’s vein and aneurysmal abnormalities.

A girl suffering from this rare condition was born without complications, indicating that the procedure can safely treat children.

The MRI showed that the central vein was larger than 14 mm in diameter. “When a vein is 8 millimeters or more wide, we know with 90 percent certainty that the baby will be very sick after birth,” said Dr. Darren Auerbach of Boston Children’s Hospital. “It was one of the most aggressive deformities.” I have ever seen.”

The doctors performed the operation on the mother at 34 weeks of pregnancy, the operation took less than two hours.

A team of 10 doctors used ultrasound to pass a long needle through the mother’s abdomen to the part of the baby’s brain where the arteries were affected. A small amount of the substance was then injected into the vessel to prevent backflow into the veins.

Ultrasound every other day showed a decrease in the amount of blood pumped by the fetal heart by 43%. MRI scans taken before and after the operation also showed that the vein had shrunk by about 5 mm in diameter.

The child was born prematurely, two days later, without complications. She did not need heart medication or additional surgery.

Dr. Auerbach said: “This approach could revolutionize the intravenous treatment of galenic malformation. We correct a malformation before birth and prevent heart failure before it happens rather than trying to reverse it after birth. This can greatly reduce the risk of long-term brain damage or disability or death among these children.

Dr. Auerbach said: “The baby is growing remarkably well, is not taking any medication, is eating normally, is gaining weight, and there are no signs of any negative effects on the brain. It was great, because usually these children are very sick.” He confirmed that the baby, now 7 weeks old, is still in good health.

The malformation of the veins of Galen (VOGM) causes the arteries in the brain to divert blood directly into the veins instead of into the capillaries, flooding the heart and causing brain damage. Babies may not survive beyond the first few days after birth.

Current treatments are limited to the period after the baby is born, when in most cases brain damage has already occurred.

The new procedure, published in the medical journal Stroke, aims to treat the condition before it affects the baby after birth.

Dr. Carol Benson of Brigham and Women’s Hospital in Boston noted that the operation requires the care of both mother and child, and that while it is a promising way to prevent brain damage and death in infants with incurable galenic venous malformations after birth, it is at any time you have fetal surgery, there is a risk of complications, especially premature birth.

Source: Sun