World’s pioneering surgery carried out in Barcelona saves the life of a 26 week old foetus

A medical team from the Catalan capital’s Hospital Clínic and the Sant Joan de Déu Children’s Hospital, in Greater Barcelona, cured a foetus with a lung malformation in a world pioneer intervention. The baby girl is currently 16 months old, has a normal life, and no further surgery is expected. The malformation was diagnosed in the 20th week of pregnancy, surgery took place in the 26th, and Alaitz was born in the 38th week.

CNA / María Belmez

March 13, 2012 11:12 PM

Barcelona (ACN).- For the first time, Catalan doctors carried out a surgical procedure to cure a lung malformation on a 26-week-old foetus. This a world’s pioneering surgery, developed by a medical medical team from Barcelona’s Hospital Clínic and Sant Joan de Déu Hospital. The foetus went through surgery inside her mother’s womb in order to cure a total obstruction of the main bronchial tubes that put her life in serious risk. The lung malformation had put pressure on the heart and could provoke fatal heart failure. The malformation was diagnosed in the 20th week of pregnancy, surgery took place on the 26th, and the baby girl was born in the 38th week. 13 days after Alaitz was born, a second surgical procedure was needed to repair the affected lung. On Tuesday, the world’s first surgery was deemed a great success, since Alaitz is now 16 months old, has a completely normal life and no further surgery is expected. The medical team developed an endoscopic method through which a laser was introduced inside the foetus via the mouth. Then it goes through the larynx and the trachea, until the bronchial tube is reached and the obstruction removed.

On Tuesday, the Head of the Mother-Foetal Service of the Hospital Clínic, Eduard Gratacós, told the press that it was a particularly difficult case to solve. Gratacós explained that a surgical intervention was required, as otherwise the foetus would have died. Until now, in all the other similar cases, the baby has died due to respiratory problems or heart failure.

Alaitz was suffering from a lung malformation that was pressuring the heart and could provoke a fatal failure of the organ. One of Alaitz’s main bronchial tubes (the pipes linking the trachea with the lungs) had a malformation that forced the accumulation of secretions inside the lung. The lung became inflamed and behaved as a large and compact mass inside the thorax, which pressures the heart and ultimately can cause heart failure and the patient’s death.

The mother’s regular gynaecologist detected the malformation in her 20th week of pregnancy. Alaitz’s mother, Mònica, was sent to the Hospital Clínic, where they offered her the possibility to carry out this world’s pioneering procedure. Mònica explained that she “saw it very clearly”, as she did “not have any other option”. Doctors had ensured her that without the intervention the foetus would have died, very likely before birth.

Surgery was carried out when the foetus was 26 weeks old, and with a weight of 800 grams. Gratacós explained that the procedure was “extremely delicate” as tissue is very thin and the distance from the heart is very small. That is why the surgery had to be fast, and it only lasted 30 minutes. A laser was introduced inside the foetus via her mouth. Then it went through the larynx and the trachea, until the bronchial tube was reached. The laser drilled the obstructed lung, which was drained. The affected lung reduced in size. The other lung, the healthy of the two, began a quick recovery and reached normal growth.

The second and last intervention

The pregnancy ended on the 38.6 week, when Alaitz was born weighting 2,540 grams. She did not need initial reanimation but presented a minor respiratory failure. 13 days later, a second surgical procedure was undertaken to remove the lung lobes damaged by the bronchial lesion. It was the last surgery required.

At the present time, the superior lobe has expanded its size and it has compensated the function of the other two, allowing her to develop an absolutely normal life, as the paediatrics surgeon Montserrat Castañón explained. Mònica, Alaitz’s mother, explained that her daughter has a “completely normal” life, and that she does the things that any other child of her age would be doing. Mònica wanted to thank the entire medical team for their work.

Pioneer surgery

The Head of the Cardiology Unit of the Hospital Clínic’s Mother-Foetal Service, Josep Maria Garcia, told the press that never before has this surgical procedure been undertaken in the world. However, he explained that they knew what was required and how to do it.

Gratacós said that this surgery had been developed by a public hospital, part of Catalonia’s public healthcare system. Gratacós defended the need to have a high-quality public health system. “Without high quality public medicine, they [procedures] are not possible”, he stated.