Doctors at Cleveland Clinic, Ohio, perform fetal surgery to remove a rare heart tumor. The delicate operation involved partially removing the baby from his mother's womb at 26 weeks, removing the tumor, and placing the baby back in his mother's womb for ten more weeks before being born at full term, the Cleveland Clinic said in a statement. Today, the baby is doing well.
In 2021, Rylan Harrison Drinnon was diagnosed with intrapericardial teratoma with fetal hydrops in utero. Cleveland Doctors said it is an extremely rare condition leading to heart failure if left untreated.
Dr. Darrell Cass, director of Cleveland Clinic'sClinic's Fetal Surgery and Fetal Care Center, said that Cleveland Clinic is the second academic medical center globally that has performed this fetal surgery successfully with continued pregnancy and delivery.
Time was of the essence.
According to Cass, when the patient arrived at Cleveland Clinic, imaging tests showed that the tumor kept growing and the 'fetus' heart function deteriorated.
The tumor, which was the size of a peach pit, was constricting the left side of the fetus, cutting off circulation and causing an accumulation of fluid around the heart and other organs.
Doctors referred the parents to Cleveland Clinic for this particular case. A multidisciplinary team from Cleveland Clinic and Children's Clinic was formed to perform the surgery in May 2021 to address the tumor tissue.
The team, led by Dr. Hani Najm, Cleveland Clinic'sClinic's chair of pediatric and congenital heart surgery, made a "caesarian section-like incision" that exposed the mother's uterus. She then used ultrasound to locate the placenta and fetus. The team opened the uterus, lifted Ryan's arms to reveal his chest, then removed the tumor from the baby's beating heart before placing him back in the uterus. The procedure lasted 3 ½ hours.
As soon as doctors removed the tumor, the compression of the left atrium disappeared. The heart also showed a "nice" blood flow that was almost back to normal, Najm reported.
The Cleveland Clinic wrote that the baby and the mom recovered well. Baby Ryan was able to remain in the womb until near full term.
On July 13, ten weeks after the surgery, maternal-fetal medicine specialist Dr. Amanda Kalan, who attended the surgery, monitored Sam'sSam's aftercare and delivery of the healthy baby boy by C-section.
Cass then proudly announced the massive success of the team's operation. He also said that there was only one previous incidence similar to this documented in the world's medical literature.
According to Najm, the innovative fetal surgery gives hope to other families who may receive "similar devastating diagnosis."
Close heart monitoring
The doctors said that Ryan would likely need surgery to reposition his sternum, which did not heal properly in the womb. Doctors will closely monitor his heart health to ensure that the tumor does not reappear.
The parents are beyond grateful for the rare, lifesaving intervention.
