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Texas Children's Hospital Fetal Center Performs Successful Open Fetal Surgery To Treat Fatal Condition

Wed, 04/23/2014 - 9:58am

Physicians at Texas Children's Fetal Center proudly announce the birth of Baby Cabellotrejo, a boy born healthy at Texas Children's Pavilion for Women following a complex pregnancy that included open fetal surgery. Early in the pregnancy, doctors diagnosed baby boy Cabellotrejo with a very large lung mass, called congenital cystic adenomatoid malformation, or CCAM for short. Mom and baby were transferred from their hometown of Austin, to Texas Children's Fetal Center in Houston, where a nationally recognized, multidisciplinary team of surgeons intervened with an open fetal surgery that saved the baby's life. During the procedure, surgeons partially removed the baby from his mother's womb, opened the baby's chest and removed the giant mass, returning him safely back into his mother's womb less than 30 minutes later.  The fetal heart failure resolved, and the baby and mother subsequently recovered smoothly; mom remained pregnant for 11 (+) weeks before she delivered her health baby boy. To date, only two other centers in the world have been successful at treating this rare and complex medical condition.

A CCAM is an abnormal growth of malformed lung tissue that is the result of abnormal organ development. The adenomatous overgrowth of terminal bronchioles and reduced number of normal alveoli may cause significant pulmonary effects. It is incredibly rare for these malformations to grow to such a large size as to lead to fetal heart failure, a condition that is very difficult to treat prenatally. The fetus continued to deteriorate despite medical treatment.

"Fetal surgery was the only hope for this baby boy who was sure to die without surgical intervention. The good outcome achieved in this case is the result of great teamwork, including the contributions by our expert fetal radiologists, cardiologists and maternal fetal surgery team. I am so pleased this baby has recovered fully and now has the hope of a completely normal life," said Dr. Darrell Cass, co-director of Texas Children's Fetal Center, and lead surgeon on this case. "Baby Cabellotrejo is a fighter and a survivor. We are ecstatic that his parents have delivered a healthy baby boy."

The open fetal surgery took place on Jan. 16, 2014, and involved removing the mass, which had overgrown the left lower lung of the fetus. In order to reach the mass, the arm and part of the shoulder were extracted from the mother's womb. Time and precision are, of course, crucial in the success of this surgery. In addition to an expert operating room team and pediatric anesthesiologists, a multidisciplinary team of specialists led the surgery from Texas Children's Fetal Center, including:

  • Dr. Darrell Cass, co-director of Texas Children's Fetal Center and associate professor, departments of surgery, pediatrics and obstetrics and gynecology, at Baylor College of Medicine
  • Dr. Oluyinka O. Olutoye, co-director of Texas Children's Fetal Center and professor of surgery, pediatrics and obstetrics and gynecology at Baylor
  •  Dr. Wesley Lee, co-director of Texas Children's Fetal Center and professor of obstetrics and gynecology at Baylor
  • Dr. Michael Belfort, obstetrician and gynecologist-in-chief at Texas Children's Hospital and chair of obstetrics and gynecology at Baylor
  • Dr. Nancy Ayres, director of non-invasive cardiac imaging at Texas Children's Hospital and assistant professor of pediatrics at Baylor
  • Dr. Rodrigo Ruano, co-director of Texas Children's Fetal Center, and professor of obstetrics and gynecology at Baylor
  • Dr. Christopher Cassady, chief of fetal radiology at Texas Children's, and associate professor of radiology at Baylor
  • Dr. Alireza Shamshirsaz, department of obstetrics and gynecology and maternal fetal medicine at Texas Children's Hospital

"Texas Children's Fetal Center is one of only a few centers in the world capable of such a complex surgical intervention," Belfort says of his team. "We have acquired a team of experts from around the world who focus specifically on fetal surgery, all with top technical skills, and a commitment to medical innovation, which makes our center one of a kind."

Texas Children's Hospital has performed 59 open fetal surgeries since 2003. 

Texas Children's Fetal Center is located on the Pavilion for Women's fourth floor and is one of only a handful of facilities in the world to offer a full spectrum of maternal and fetal care. Comprehensive services include management of any complex pregnancy, genetic counseling and the full range of fetal diagnostic procedures. The Fetal Center also provides highly specialized fetal surgeries for a number of congenital malformations. Texas Children's Fetal Center is among the nation's leaders in providing high-risk maternal care and the diagnosis and treatment of abnormalities in unborn and newborn infants.

For more information, please visit http://women.texaschildrens.org/fetalcenter/

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