2023-05-12 14:51:06
The child suffered from an aneurysm of the vein of Galen, a rare disease which can have serious consequences on the infant. The operation is a first and gives rise to great hopes.
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Amelie Rugraff
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The success of this operation could constitute a revolution for the next children affected by this rare disease. On March 15, a fetus with a Vein of Galen aneurysm was operated on in its mother’s womb, reports the British press agency SWNS. The results of the operation were published Thursday, May 4 in the scientific journal Stroke .
This is not the first time that intrauterine operations have been performed. On the other hand, surgeons had never before resorted to an operation for this type of malformation. This is an important detail, because the operation, hitherto always performed after birth, often occurs too late. “From 50 to 60% of babies with this disease immediately become very ill. And for those, it looks like the death rate is around 40%“, said to CNN Dr. Darren Orbach, expert in the treatment of Vein of Galen malformation. “About half of children who survive have severe neurological and cognitive impairment“, he added.
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“An ideal candidate”
Galen’s vein aneurysm causes too much blood to flow into the brain. In people with an aneurysm, the vein of Galen is directly connected to the artery that carries blood from the heart to the brain, rather than to small capillaries that help reduce blood flow. The irrigation of the brain is then too strong, which can cause epilepsy or retarded development of the child. The purpose of the operation is to embolize the vein, by inserting thin metal coils into the vessel.
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When they learned of their daughter’s illness, the parents, Derek and Kenyatta Coleman, decided to participate in a clinical trial launched at Brigham and Women’s Hospital and Boston Children’s Hospital. “She was an ideal candidate. The baby didn’t have any heart failure issues yet, nor was there any brain damage. But the malformation was getting bigger and bigger.“, detailed to BFM TV Dr. Carole Benson, a radiologist at Brigham and Women’s Hospital, who took part in the operation. The operation took place a month after the detection of the malformation, during the thirtieth week of pregnancy of this mother of already three children. Two injections were given to the fetus, to make sure it didn’t move and to ease the pain. Via a needle inserted into the mother’s abdominal wall, a catheter was placed on the child’s skull, which made it possible to insert the small metal coils.
A healthy baby
The little girl was born four weeks later, five weeks early. “In the immediate period of the birth she was very stable and did not need any of the immediate treatment they usually need, whether it was placing coils or supporting heart function with medication“, assured CNN Dr. Louise Wilkins-Haug, who participated in the operation. The operation is therefore a success. She might have aconsiderable impact“, assures Fox News Professor Gary Satou, fetal cardiologist at the University of California at Los Angeles. “As always, a number of these fetal cases will need to be performed and followed up to establish a clear pattern of improved neurological and cardiovascular outcomes.“said Gary Satou, reports SWNS. “The national clinical trial will therefore be crucial to obtain adequate data and hopefully positive results.».
«There are caveats“, also estimated with SWNS Professor Colin Derdeyn, neuro-interventionist radiologist at the University of Iowa. “A single successful case is not enough experience for us to conclude that the risks of this procedure are worth the benefits.». «However, the positive hemodynamic changes observed in utero and after birth are truly encouraging.“, he added.
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