Doctors Operate on 25-Week-Old Unborn Baby’s Heart After Practicing on a Grape

National   |   Steven Ertelt   |   Oct 15, 2013   |   6:30PM   |   Washington, DC

A team of doctors at CHA Hollywood Presbyterian Medical Center successfully widened a tiny aortic valve using a hair-fine wire, an 11-centimeter needle a tiny balloon and catheter. The baby in question would otherwise have been born with a life-threatening condition.

The unborn baby’s heart was developing with one valve too narrow, a condition known as severe aortic stenosis. This meant the amount of blood coming into the heart was being severely restricted and it was backing up in the left ventricle. Doctors said the operation was already showing signs of success.
A video of the operation shows the tiny needle, left, carefully entering the beating heart, which is darker.

From a Los Angeles Times report:

A wire the width of a hair. A balloon just a few millimeters wide. A needle measuring 11 centimeters exactly.

These were the tools that a team of doctors in Los Angeles used to open up a narrow aortic valve in the heart of a 25-week-old fetus still growing in its mom’s belly.

The procedure is known as a fetal aortic valvuloplasty. It was also a first for Southern California.

A few weeks before the doctors gathered in the operating room at CHA Hollywood Presbyterian Medical Center in Los Angeles, fetal cardiologist Dr. Jay Pruetz of Children’s Hospital Los Angeles diagnosed the fetus as having severe aortic stenosis. That means the baby’s aortic valve was very tight. Blood was backing up in the left ventricle of the baby’s heart, keeping it from pumping normally.

If doctors had not intervened, the left ventricle would not develop properly, and the baby would likely be born with a life-threatening condition called hypoplastic left heart syndrome.



After practicing a few times with a model of jello and a grape — the grape standing in for the heart, the jello standing in for the surrounding body — the doctors performed the procedure on Sept. 25. Mom had local anesthesia and was sedated. The baby was given anesthesia and a muscle relaxant so it wouldn’t switch positions at an inopportune time.

Dr. Ramen Chmait, assistant professor at Keck School of Medicine of USC and director of Los Angeles Fetal Therapy, inserted a thin metal tube (he calls it a needle) through the mom’s belly, into the uterus, through the amniotic cavity and into the fetus’s chest.