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Update on Billy 
 

Only a few weeks along in the pregnancy, as he was growing inside his mother, a large lung mass known as a Bronchopulmonary Sequestration was shifting Billy’s heart and underdeveloped lungs to the side. “We started to wonder if there was going to be a baby,” remembers Billy’s mother Julie.

The team at the St. Louis Fetal Care Institute knew they had to do something to help. When traditional therapies didn’t work, they searched the globe for an answer and found one in the Netherlands. Doctors there were using laser ablation to stop blood flow to these types of masses.

During the surgery a small needle is inserted next to the blood vessel feeding the BPS. Then, a laser fiber is targeted and fired at the blood vessel, which is about as thick as a dime. The goal of the operation is to use laser energy to stop the blood flow to the BPS, causing it to stop growing. As the BPS shrinks, the fetal heart and lung start growing normally.

“We had the knowledge, experience and technology to successfully perform this procedure here at the St. Louis Fetal Care Institute, and we knew it could be Billy’s only chance at life,” says Mike Vlastos, MD, the director of the St. Louis Fetal Care Institute.

Because this was a new procedure, the case was presented to the St. Louis Fetal Care Institute Scientific and Ethical Review Board. The committee evaluated Billy’s case and felt that the possible benefit of performing the new laser procedure outweighed the risk, given the life-threatening situation. 


Having decided surgery was the right choice for their family, Julie anxiously awaited the Board’s response. “We were on pins and needles waiting for a response from them. At 5 p.m. the phone rang and we were told to be at the hospital at 7 a.m. the next morning for the surgery,” explained Julie.

The surgery was successfully performed at SSM St. Mary’s Health Center. Doctors worked together to guide the needle right next to the feeding vessel to the BPS. “We inserted the laser fiber, and after several firings, the blood flow to the BPS was stopped,” said Dr. Vlastos.

Julie woke up, and after this high risk, new procedure, the only evidence that she had surgery was a small band-aid where the needle had been placed. “The surgery was a breeze, but we were so nervous for the upcoming ultrasounds,” she says.



A few weeks after the surgery, Julie and her husband Ben finally received good news. “We were optimistic to see on ultrasound that the mass was shrinking and that Billy’s lungs were growing,” explains St. Louis Fetal Care Institute Nurse Coordinator Katie Francis. “The sense of excitement and relief that spread through the room was unforgettable.”

A few weeks after surgery, Billy made his grand entrance to the world. “We were nervous, they said Billy may need to go to the NICU (neonatal intensive care unit) depending on how his lung were after birth,” explained Julie. “Dr. Vlastos was there to make sure everything was okay, and along with us was thrilled when Billy started crying the moment he was born.” Billy was doing so well he didn’t need to spend any time in the NICU, and went home two days after delivery.

When he was six months old, Billy had surgery to remove what was left of the BPS. “We found that Billy’s lungs were entirely normal, and his BPS was very small and scarred, unlike a normal BPS.  We believe this is because we had cut off the blood supply during the pregnancy,” explained Dr. Vlastos. “We have every expectation that Billy will lead a full, healthy, normal life.”

Billy recently celebrated his third birthday and Julie says he is full of energy. He stays busy playing with his Power Wheels and enjoying life. He doesn’t have any lasting lung issues and is a healthy preschooler.

Since Billy’s surgery, the team at the St. Louis Fetal Care Institute has performed three more life-saving laser ablations on Bronchopulmonary Sequestrations, and remains the only center in the U.S. to perform them.


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