HCM City hospitals perform Southeast Asia’s 1st fetal cardiac surgery

January 10, 2024, 5:12 pm

<p>A fetal cardiac intervention was successfully performed by doctors from Từ Dũ Hospital and Children’s Hospital 1 in HoChi Minh City, the first ever in Southeast Asia. <em>(Photo from Từ Dũ Hospital)</em></p>

A fetal cardiac intervention was successfully performed by doctors from Từ Dũ Hospital and Children’s Hospital 1 in HoChi Minh City, the first ever in Southeast Asia. (Photo from Từ Dũ Hospital)

HCM CITY – Doctors from Từ Dũ Hospital and Children’s Hospital 1 in Ho Chi Minh City successfully performed a fetal cardiac surgery on January 4, the first ever in Southeast Asia.

It was done to unclog a fetus' heart valve through the mother’s womb.

This, after the baby of a 26-year-old woman, who was then in her 26th week of pregnancy, was diagnosed in early November 2023 with several congenital heart defects – hypoplastic right heart syndrome (HRHS) and a minuscule pulmonary valve opening.

In HRHS, the structures of the right side of the heart are underdeveloped, causing inadequate blood flow to the lungs and, thus a lack of oxygen.

The mother, from Đà Nẵng City, was transferred from Đà Nẵng Hospital to Từ Dũ Hospital for further prognostications.

The condition kept worsening and eventually threatened to become fatal before the final consultation scheduled on January 3.

Normally, if an intervention to open the pulmonary valve is not done, there would be a miscarriage.

Neonatal death would also occur if, instead, the mother is forced to deliver due to preterm birth and the infant’s serious heart disease, experts from both hospitals said during the final consultation.

But in this case, the doctors warned of a likely stillbirth if no intervention was done, or the baby being born alive but with cardiac defects and requiring difficult surgeries.

“In the case of cardiac surgeries, the fetal intervention has a higher success rate than surgeries done on newborns since the fetus’ valve will be able to heal naturally with the help of stem cells, leaving no scars behind,” Từ Dũ Hospital director Dr Trần Ngọc Hải said.

The surgery was then done in week 32 of the pregnancy, Đỗ Nguyên Tín, deputy head of the cardiac department at Children’s Hospital 1, told Tuổi Trẻ (Youth) newspaper.

A surgical needle was used to penetrate the mother’s uterus wall and reach through the amniotic sac to the right side of the fetus' heart.

“Fetal cardiac intervention is the most complex process,” Hải said. “It requires absolute precision to anaesthetize a fetus.”

The child’s heart was the size of a lime, with only 2-3 sq. cm. for each cardiac chamber and 4 millimeters for the pulmonary valve opening, making the surgery harder and more demanding.

However the skill of the medical personnel and the use of high-quality surgical equipment meant the 40-minute surgery was a success.

“It was also the mother’s courage and trust that empowered us,” Trịnh Nhựt Thư Hương, head of the prenatal care department at Từ Dũ Hospital, said.

Fetal cardiac unclogging has only been around for five years, with just a few countries like Brazil and Poland succeeding at it.

Tín is hopeful the success will help further foster children’s heart valve surgery in Vietnam.

Deputy director of the city Department of Health, Nguyễn Anh Dũng, said the surgery shows the efforts made to innovate technological solutions in healthcare.

Vice chairman of the city People’s Committee, Dương Anh Đức, said it is also a new advancement that takes the city’s medical sector at par with its counterparts in developed countries.

“There has been no abnormality since the surgery, and both the mother and the child are in great condition with free post-surgery care. They are expected to be discharged on January 8,” he said.

Each year around ten to 12,000 Vietnamese children are diagnosed with congenital cardiac defects, meaning one such child is born every 15 minutes.

Around 50 percent are in severe condition, and 5,000 get to receive cardiac surgeries. (VNS)