Doctors performed the on January 4. (Photo Courtesy of HCM City’s Department of Health)Hanoi (VNS/VNA) – A second foetal cardiac intervention
has been successfully performed by doctors from and Children’s
Hospital No.1 in Ho Chi Minh City.
During prenatal examinations, 27-year-old pregnant woman, N.P.P.A., from
District 3, HCM City, was diagnosed with at 21 weeks
of pregnancy, specifically progressive aortic valve stenosis. She underwent
amniocentesis for genetic testing, which showed no abnormalities.
By January 11, the pregnancy had progressed to 29 weeks with severe aortic
valve stenosis. After consultations, foetal experts and paediatric
cardiologists unanimously concluded that emergency foetal intervention was
crucial in this case.
Without intervention or if delayed until after 29 weeks of gestation to dilate
the aortic valve, the risk of foetal death would be extremely high.
The foetus faced the possibility of either dying in the womb, with a stillbirth
rate exceeding 30%, or progressing to hypoplastic left ventricle syndrome with
a 50% risk of a univentricular heart wall (requiring multiple surgeries after
birth for temporary return to univentricular circulation or complete treatment
with a heart transplant).
Cardiologists determined that foetal cardiovascular intervention
at this juncture was appropriate. However, predicting the foetal position for
cardiac catheterisation presented challenges due to excess amniotic fluid and
frequent foetal position changes.
The surgery started at 9am on January 12.
The surgical team faced the expected challenges, with the foetus
frequently changing positions, making it difficult to insert the needle into
the left ventricle and onto the aortic valve.
The intervention at Tu Du Hospital took 20 minutes to position the
needle correctly, and it was then handed over to the heart valve
catheterisation team at Children’s Hospital 1 to complete the crucial final
step – aortic valvuloplasty.
Post-surgery, the pregnant woman was closely monitored in the
operating room for 15 minutes, and the stabilised condition of foetal
pericardial effusion was confirmed.
The successful surgery concluded at 11am on the same day, with continuous
monitoring of the pregnant woman post-surgery. By 1pm, the foetal pericardial
effusion was well controlled, the foetal heart rate was normal, and the
mother’s condition was stable.
Earlier on January 4, the same expert team from Tu Du Hospital and
Children’s Hospital 1 achieved a milestone by conducting Vietnam’s first
foetal interventional cardiac catheterisation. This involved a pregnant woman
who, during her first pregnancy, was monitored in Da Nang city. Transferred to
Tu Du Hospital due to the foetus’s severe heart abnormalities – a birth defect
without a pulmonary valve opening and right ventricular hypoplasia – the
intervention successfully addressed the issues.
Subsequent examinations showed good flow through the foetal pulmonary valve,
with no pericardial effusion.
Both interventions were executed with absolute precision, marking a significant
advancement in technical expertise comparable to that of developed countries in
the region.
Through the initial two foetal interventional cardiac catheterisations and
first-hand observation of the seamless coordination by obstetric and paediatric
experts at Tu Du and Children’s Hospital 1, the Ho Chi Minh City Department of
Health said several decisive factors contributed to the success of these
interventions.
These include accuracy in ultrasound techniques by paediatric cardiologists at
Children’s Hospital 1, demonstrating precision in diagnosing foetal congenital
heart lesions, serving as the crucial guide for accurate foetal cardiac
catheterisation intervention.
Experience and precision in foetal intervention performed by doctors from the
two hospitals are also crucial factors.
The Ho Chi Minh City Department of Health views this success as an initial
outcome in the specialised field of foetal congenital heart intervention./.
Source: VietnamPlus
