Gynecology Faq

Life-Saving In Utero Heart Procedure

09/15/2011 -

Life-Saving In Utero Heart Procedure
WABC-Channel 7
Sept. 15, 2011


Watch this video.

Sade Baderinwa, Co-Anchor: This is a real interesting story: a baby on Long Island is alive today thanks to a rare procedure performed on his heart before he was even born.

Diana Williams, Co-Anchor: Today his parents were able to thank their doctors at North Shore University Hospital. Dr. Jay Adlersberg is off tonight; Dr. Sapna Parikh joins us with the story. Sapna?

Dr. Sapna Parikh, Health Reporter:
You’re about to meet this beautiful ten-month-old boy. He’s strong, he’s active, and most importantly, he is healthy. But when his mother was just a little over three months pregnant, she and her husband were forced to make an incredibly difficult decision.

Suzanne Francis, Dante’s Mother: It’s pretty much a mother’s worst nightmare to receive the news that there’s a problem with your baby.

Dr. Sapna Parikh:
Today that baby is happy and squirming around in his mother’s lap. Ten-month-old Dante Francis was the star from the moment his parents brought him back to the hospital. At a press conference with their doctors, Suzanne and Robert Francis told us their story. When Suzanne was only thirteen weeks pregnant, doctors discovered liquid around the heart of the fetus. It’s a common condition that often resolves on its own, but this time it got worse.

Dr. Angela Romano, North Shore University Hospital: In this particular case, the fluid was quite large around the baby’s heart, and therefore posed a threat to the survival of the fetus.

Dr. Sapna Parikh: The couple was devastated, but agreed to let the doctors perform a procedure which has been done, at most, ten times worldwide. It meant inserting a needle into the area around the baby’s heart to remove the fluid while the heart is still beating. The fetus had not even reached 20 weeks gestation, at which time the heart is barely the size of a quarter.

Dr. Nidhi Voorha, North Shore University Hospital: The risk of the procedure was that we were going into a very narrow space around the baby’s heart, and there was a risk that we could cause bleeding by puncturing the heart, or we could even cause loss of the pregnancy completely.

Dr. Sapna Parikh: Dr. Voorha and her colleagues succeeded, and Dante came into the world six months later.

Suzanne Francis: He’s good, and we really appreciate that, and I just think it was a miracle what they could do.

Dr. Sapna Parikh: And his parents say they had extra testing because of fertility treatments, so they credit that testing and their doctors for saving their baby. And they named him Dante, by the way, because it means eternal or everlasting in Latin. Diana and Sade, back to you.

Suzanne Francis, Dante’s Mother: It’s pretty much a mother’s worst nightmare to receive the news that there’s a problem with your baby.
 
Sade Baderinwa: Aww, that’s great. 

Diana Williams: That’s very sweet. Thanks, Sapna.

* * * * * *

Baby Only 10th to Have In Utero Procedure
Newsday
By: Delthia Ricks / delthia.ricks@newsday.com
September 16, 2011


Early during pregnancy with their second child, Suzanne and Robert Francis faced the decision of their lives: whether to allow doctors to treat their son while still in the womb.

Worldwide, the delicate heart procedure had been done only nine times.

The Huntington couple Thursday was more than happy the procedure was performed. Dante, now 10 months old, is active and happy -- his heart in perfect health.
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"This was the hardest decision ever," Suzanne Francis said during a news conference at North Shore University Hospital in Manhasset, where she and her family reunited with their doctors.

"I did pray," Francis, 46, said, recalling a tense five weeks between the diagnosis and operation. "I really had to trust and know that this was going to be OK."

While in the womb Dante developed a life-threatening accumulation of fluid that filled his pericardium -- the protective sac around the heart. The condition was diagnosed during the 13th week of gestation during a routine examination.

Dr. Angela Romano, Dante's pediatric cardiologist, said the pericardium is supposed to fit tightly on the heart, not fill like a water balloon around it.

When fluid increases, Romano said, it decreases the amount of blood the organ pumps. The condition can lead to lung compression, heart failure and, if untreated, death in the womb.

Dante underwent the procedure in June 2010. At the time, he was barely 7 inches long and his heart was about the size of a quarter.

A team of maternal/fetal experts headed by Dr. Nidhi Vohra was assembled to perform the procedure known as in utero pericardiocentesis.

Guided by ultrasound technology, Vohra inserted a long needle through the mother's abdomen and into Dante's pericardial sac. She withdrew a half teaspoon of fluid, an amount she called astonishing given the size of the heart.

The procedure lasted about a minute.

"It was a miracle what they were able to do," Robert Francis, 50, said Thursday.

Dante's operation became the 10th of its kind to be documented globally, said Vohra, who searched Pub Med, a vast database of medical literature to find others. She said it's virtually impossible to know whether other doctors in New York have performed it because physicians don't always publish their work on fetal procedures.

Suzanne Francis said the reunion with her doctors helped recall numerous struggles associated with Dante's development and birth. The baby was conceived through assisted reproductive technology.

"I had only a 2 percent chance of conceiving because of my age," said Francis, whose daughter, Madeline, was born four years ago. "There aren't enough words to describe how much I love him. I love both my children so much."

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