Revolutionary Fetal Surgery Gives Girl Chance at Life
Doctors at St. Louis Fetal Care Institute Use New Method To Treat Life Threatening Fetal Lung Masses Before Birth
The ultrasound images told the story: A lung mass was filling the majority of Angela Murphy’s baby’s chest. The mass was compressing the baby girl’s lungs and heart to the point where survival after birth was unlikely. Devastated, the first-time mother looked for a way to save her baby girl, Delaney. Dr. Mike Vlastos, the Director of the St. Louis Fetal Care Institute, had an answer. His team, the only one in the country with experience performing a fetal laser surgery to cut-off blood flow to a fetal lung mass, essentially destroying it before the baby is born, could give Delaney the chance at life.
The surgery, known as fetal laser ablation for bronchopulmonary sequestration (BPS), has only been performed one other time in the United States, at the St. Louis Fetal Care Institute in 2011. During the procedure, doctors insert a needle into the mother’s belly and into the womb. Then, the needle is advanced into the baby’s chest, then into the BPS where a laser fiber is introduced through the needle and targeted at the abnormal blood vessel going to the BPS. The laser fires and blocks the blood flow, causing the mass to stop growing. The goal of the operation is to reverse the process by which the BPS is causing heart failure in the fetus. After the surgery, the BPS steals less blood flow from the fetus, and the heart and lungs start growing more normally as the BPS shrinks in size.
“The mass on Delaney’s lung was taking up more than half of her chest volume, it was four times the size of her lung. There was no room for her lungs to properly develop and her heart was being shifted to the side,” says Dr. Vlastos. “If we didn’t do something her chances at survival were slim.”
On Aug. 3, 2012, a 22-week pregnant Angela went in for the surgery. “It was a scary day, but I knew this was the only option to give my baby a chance at a long, healthy life,” says Angela. The surgery was a success and the mass continued to shrink throughout the remainder of Angela’s pregnancy. On Nov. 7, 2012, a healthy 6 lb., 15 oz. Delaney was born at SSM St. Mary’s Health Center in St. Louis.
“The results we have seen from this procedure are unprecedented,” Dr. Vlastos says. “When we performed the surgery Delaney’s lungs were only 20% of what a normal baby’s lungs would be at that point of development. When she was born her lungs were normal size. We had similar results when we performed the procedure on a little boy last year.”
As a precaution, the remainder of Delaney’s lung mass will be removed in a few months. “These masses have been shown to increase the risk of lung cancer later in life, so it is best for them to be removed early,” says Dr. Vlastos. After the surgery Delaney should not have any developmental challenges, and is expected to lead a healthy normal life.
About The St. Louis Fetal Care Institute
The St. Louis Fetal Care Institute is a partnership between SSM Cardinal Glennon Children’s Medical Center, SSM St. Mary’s Health Center, and Saint Louis University School of Medicine. Bringing together renowned maternal fetal medicine (MFM) specialists, pediatric and fetal surgeons, specialized nurses, cutting-edge technology, and a family-oriented approach, The Institute offers state-of-the-art diagnostic methods and treatment options for families whose unborn babies are facing medical challenges. It is the